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Medicine (Baltimore). 2019 Aug;98(34):e16927. doi: 10.1097/MD.0000000000016927.

Influence of hypercholesterolemia and diabetes on long-term outcome in patients with stable coronary artery disease receiving percutaneous coronary intervention.

Author information

1
Division of Cardiology, Department of Medicine, Taichung Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taichung.
2
Department of Medicine, School of Medicine, Tzu Chi University, Hualien.
3
Laboratory of Epidemiology and Biostatistics, Changhua Christian Hospital, Changhua.
4
Department of Pediatric Emergency Medicine, China Medical University Children's Hospital.
5
Department of Medicine, College of Medicine, China Medical University.
6
Department of Public Health, Chung Shan Medical University.
7
Department of Pediatrics, Children's Hospital, China Medical University.
8
Department of Medical Research, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan.

Abstract

Coronary artery disease (CAD) is a life-threatening medical emergency which needs urgent medical attention. Percutaneous coronary intervention (PCI) is common and necessary for patients with CAD. The effect of hypercholesterolemia and diabetes on long-term outcomes in patients with stable CAD receiving PCI is unclear.In this study, patients with stable CAD who underwent PCI were prospectively divided into 4 groups according to the presence or absence of diabetes or hypercholesterolemia. Clinical characteristics, risk factors, medications, angiographic findings, and outcome predictors were analyzed and long-term outcomes compared between groups.Of the 1676 patients studied, those with hypercholesterolemia and diabetes had the highest all-cause mortality rate after PCI (P < .01); those with diabetes only had the highest cardiovascular (CV) mortality (P < .01). However, the 4 groups did not differ in rates of myocardial infarction (MI) or repeated PCI. In Kaplan-Meier survival analysis, patients with diabetes only had the highest rates of all-cause mortality and CV mortality (both P < .001). In the Cox proportional hazard model, patients with both hypercholesterolemia and diabetes had the highest risk of all-cause mortality (hazard ratio: 1.70), but groups did not differ in rates of MI, CV mortality, and repeated PCI.With or without hypercholesterolemia, diabetes adversely impacts long-term outcomes in patients receiving PCI. Diabetes mellitus seemed to be a more hazardous outcome predictor than hypercholesterolemia. Hypercholesterolemia and diabetes seemed to have an additive effect on all-cause mortality in patients after receiving PCI.

PMID:
31441878
DOI:
10.1097/MD.0000000000016927
[Indexed for MEDLINE]
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