0704 GMT June 25 2017
Quoting Dr. Joo-Yong Hahn, from Samsung Medical Center in Seoul, reuters.com reported, “Although intensive glucose control had no benefit on the rate of major cardiovascular events in previous studies, our data suggest that strict glucose control after Percutaneous Coronary Intervention (PCI) can improve long-term clinical outcomes in diabetic patients.
“Heart disease is the major cause of death among people with type 2 diabetes.”
Although intensive blood sugar control is known to reduce damage to tiny blood vessels that are involved in many of the nerve and circulatory effects of diabetes, it’s not clear if the same is true for major arteries such as the ones that carry blood to the heart.
The researchers studied 980 patients with type 2 diabetes who had undergone to clear a blocked coronary artery and place a supportive mesh tube known as a stent. Hahn’s team followed the patients’ health for up to seven years.
They looked at long-term blood sugar control using a measurement known as hemoglobin A1c (HbA1c or A1C), and used it to compare the patients’ risks of death, heart attack, repeat catheterizations and stroke over the study period.
The researchers defined good control as an A1C score below 7.0 and poor control as A1C of 7.0 or higher.
Then they matched patients according to other risk factors and ended up with 322 pairs of patients for comparison.
In the overall group of 980 patients, the risk of all bad outcomes was 25 percent lower with good blood glucose control than with poor blood glucose control.
In the matched comparison, some 37 percent of patients with poor control had bad outcomes (heart attack, stroke, and so on) over the next seven years, versus less than 28 percent of patients with good control.
Most of the difference in bad outcomes between the groups resulted from a higher rate of repeat stenting in the group with poor blood glucose control.
Hahn added, “PCI is not the end of treatment for coronary artery disease. Optimal medical treatment, including glycemic control, is a cornerstone therapy after PCI.
“The effects of glucose control in type 2 diabetes may differ according to patient characteristics, such as recent cardiovascular events, baseline glycemic control status and duration of diabetes.”
The researchers wrote that more study is needed before they can conclude strict glucose control after stenting will improve long-term clinical outcomes in people with diabetes.
Dr. Azfar G. Zaman, from Newcastle University in the UK, said, “It’s important to underscore the message of good glycemic control.
“In patients with PCI there is evidence to support better outcomes and need for fewer interventions.
“This is a single center study with limited numbers, but the findings support data from other studies.”