The Influence of HbA1c Levels on Clinical Outcomes in Diabetic Patients Following Percutaneous Coronary Intervention

Background: A common risk factor for atherosclerosis is diabetes mellitus (DM). Insufficient blood sugar management, inflammation, oxidative damage, and insulin resistance are the causes of coronary artery disease (CAD) in DM. Numerous studies have demonstrated that DM is a unique risk factor for CAD. A limited number of studies have examined the relationship between the clinical outcomes of diabetic patients and their baseline levels of glycosylated hemoglobin A (HbA1c) at the time of percutaneous coronary intervention (PCI). Methodology: A prospective, single-center observational study was conducted to evaluate the impact of HbA1c levels on the clinical outcomes of 1550 patients who had PCI. They were categorized into three groups: Group 1: Nondiabetic patients with HbA1c ≤6.4, Group 2: Diabetic patients with HbA1c ≤7%, and Group 3: Diabetic patients with HbA1c >7%. Baseline demographics, pre- and postprocedure laboratory investigations, procedural details, and in-hospital, 30-day, 6-month, and 1-year major adverse cardio and cerebrovascular events (MACCE) were assessed. One-way analysis of variance was used. P ≤ 0.05 was statistically significant. Results: One-year follow-up was done for 95% of the total patients. Group 3 patients had higher 30-day (1.3%, 1.4%, 3.5%, P = 0.03), 6-month (1.7%, 4.2%, 6.6%, P = 0.001), and 1-year (4.3%, 4.4%, 9.7%, P = 0.001) rates of MACCE. The overall mortality was 61 patients; the mortality rate was 4% among the patients. Conclusions: There was a higher chance of developing MACCE among the large cohort with an HbA1c >7% who had PCI, followed by the HbA1c ≤7% group at the 30-day, 6-month, and 1-year follow-up. For patients who had PCI, intensive glycemic control may enhance clinical outcomes.