Kasai Takatoshi, Miyauchi Katsumi, Kajimoto Kan, Kubota Naozumi, Kurata Takeshi, Daida Hiroyuki
Department of Cardiology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Heart Vessels. 2008 May;23(3):149-54. doi: 10.1007/s00380-007-1021-x. Epub 2008 May 17.
There are few reports showing the relationship between diabetes and the long-term outcome following percutaneous coronary intervention (PCI) in Asians. As well, the association between glycosylated hemoglobin (HbA1c) level and outcome remains controversial. In this analysis, 748 Japanese patients including 298 with diabetes (DM) and 450 without diabetes (non-DM) who underwent PCI from 1984 to 1992 were evaluated over the long term. The mean follow-up was 12.0 +/- 3.6 years. There were 47 (15.8%) total deaths in DM and 41 (9.1%) in non-DM [hazard ratio (HR) 1.71, 95% confidence interval (CI) 1.11-2.65, P = 0.013] and 28 (9.4%) cardiovascular deaths in DM and 19 (4.2%) in non-DM (HR 2.09, 95% CI 1.14-3.81, P = 0.016). Among DM, increased HbA1c was associated with both total (HR 1.25, 95% CI 1.03-1.53, P = 0.024) and cardiovascular (HR 1.30, 95% CI 1.00-1.69, P = 0.048) mortality. Even in Asians, DM showed an increased mortality following PCI. Among DM, increased HbA1c level was also associated with mortality.
很少有报告显示亚洲人糖尿病与经皮冠状动脉介入治疗（PCI）后的长期预后之间的关系。同样，糖化血红蛋白（HbA1c）水平与预后之间的关联仍存在争议。在本分析中，对1984年至1992年间接受PCI的748例日本患者进行了长期评估，其中包括298例糖尿病（DM）患者和450例非糖尿病（非DM）患者。平均随访时间为12.0±3.6年。DM组有47例（15.8%）全因死亡，非DM组有41例（9.1%）全因死亡[风险比（HR）1.71，95%置信区间（CI）1.11 - 2.65，P = 0.013]；DM组有28例（9.4%）心血管死亡，非DM组有19例（4.2%）心血管死亡（HR 2.09，95% CI 1.14 - 3.81，P = 0.016）。在DM患者中，HbA1c升高与全因（HR 1.25，95% CI 1.03 - 1.53，P = 0.024）和心血管（HR 1.30，95% CI 1.00 - 1.69，P = 0.048）死亡率均相关。即使在亚洲人中，DM患者PCI后死亡率也会升高。在DM患者中，HbA1c水平升高也与死亡率相关。
