The role of hemoglobin A1c as a predictor of major adverse cardiovascular events in patients with type 2 diabetes mellitus after percutaneous coronary intervention: a case-cohort study

BackgroundFew studies have investigated the potential predictive value of glycosylated hemoglobin A (HbA1c) and clinical outcomes in diabetic patients after percutaneous coronary intervention (PCI), and the results of the reports have often been inconclusive and contradictory. We have organized a study to investigate the relationship between HbA1c and the occurrence of major adverse cardiovascular events (MACE) in diabetic patients after PCI.MethodsThis case-cohort study was conducted on 563 diabetic patients who underwent PCI. All studied patients had an HbA1c level measured within 24 h before angioplasty. All patients were followed for six months regarding the occurrence of MACE, and the HbA1c level was measured again at the end of the sixth month of follow-up. In the case of MACE, the subjects were considered the case group, and other non-MACE patients were included in the control group.Results505 patients remained in the study at the end of follow-up. MACE occurred in 23 (4.6%) patients during the first month and in 57 (11.3%) patients by the end of the sixth month. Baseline HbA1c was an independent predictor of MACE and mortality at the end of month-6 (P = 0.008 and 0.001, respectively).ConclusionsThe level of HbA1c at the time of admission has a significant predictive value for the occurrence of MACE in diabetic patients who undergo PCI. However, post-PCI glycemic control may not effectively reduce the risk of MACE in this population.Clinical trial registrationNot applicable. center dot Few studies have investigated the impact of HbA1c and MACE in diabetic patients after PCI, and the reports' results have often been inconclusive and contradictory.center dot Baseline HbA1c was an independent predictor of MACE and mortality at the end of month-6 but not for MACE at the end of month-1.center dot No significant correlation was observed between sixth-month HbA1c and MACE at the end of month-6.