Impact of Admission, Fasting Glucose and HbA1c Levels on in-stent Restenosis in The Patients Treated with Primary Percutaneous Coronary Intervention in 5-Year Follow-up

Abstract

Aim:Despite advances in-stent technology, in-stent restenosis (ISR) is still a major problem following percutaneous coronary intervention (PCI) and its reasons have not been fully revealed. In the presented study, we investigated the effect of admission blood glucose (ABG), fasting blood glucose (FBG) and glycated hemoglobin A1c (HbA1c) levels on coronary ISR patients with ST-elevation myocardial infarction (STEMI) who underwent primary PCI in five-year follow-up.Methods:From 2.900 patients who underwent coronary stent implantation for STEMI from January 2008 through December 2012 were retrospectively analyzed through the hospital digital recording system. Of these, 264 patients who underwent control coronary angiography during the five-year follow-up were included in the study. Patients were divided into two main group ISR and non-ISR; were divided into two subgroups diabetic and non-diabetic groups were compared with HbA1c, ABG, FBG and angiographic parameters.Results:There were 127 patients in the ISR group (diabetic: 36 non-diabetic: 91) and 137 patients in the non-ISR group (diabetic: 43 non-diabetic: 94). Regardless of the patients diabetes status, no significant difference was found between the groups with and without ISR in terms of HbA1c, FBG and ABG. A significant relationship was found between the baseline HbA1c value and having ISR only in the diabetic subgroup (p=0.01).Conclusion:This study results showed that in diabetic STEMI patients who underwent primary PCI, higher HbA1c levels were associated with higher ISR rates, but not with FBG and ABG levels.

Keywords

• st elevation myocardial infarction
• blood glucose
• glycated hemoglobin a1c
• percutaneous coronary intervention
• coronary angiography
• coronary restenosis
• diabetes mellitus