Dataset Information

Visit-to-visit HbA1c variability is associated with in-stent restenosis in patients with type 2 diabetes after percutaneous coronary intervention.

ABSTRACT: BACKGROUND:Patients with type 2 diabetes are under substantially higher risk of in-stent restenosis (ISR) after coronary stent implantation. We sought to investigate whether visit-to-visit HbA1c variability is a potential predictor of ISR in diabetic patients after stent implantation. METHODS:We consecutively enrolled type 2 diabetic patients who underwent successful elective percutaneous coronary intervention and performed follow-up coronary angiography after around 12 months. The incidence of ISR and its relationship with visit-to-visit HbA1c variability, expressed as coefficient of variation (CV), standard deviation (SD) and variability independent of the mean (VIM), were studied. Multivariable Cox proportional hazards models were constructed to analyze the predictive value of HbA1c variability for ISR. RESULTS:From September 2014 to July 2018 in Ruijin Hospital, a total of 420 diabetic patients (688 lesions) after stent implantation were included in the final analysis. During a mean follow-up of 12.8?±?1.3 months, the incidence of ISR was 8.6%, which was significantly increased in patients with higher CV of HbA1c (P?=?0.001). The mean diameter stenosis (DS), net luminal loss and net luminal gain were 22.9?±?16.8%, 0.42?±?0.88 mm and 1.66?±?0.83 mm, respectively. Greater DS was observed in subjects with higher tertiles of CV of HbA1c (P?

SUBMITTER: Yang CD

PROVIDER: S-EPMC7472579 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Visit-to-visit HbA<sub>1c</sub> variability is associated with in-stent restenosis in patients with type 2 diabetes after percutaneous coronary intervention.

Yang Chen Die CD Shen Ying Y Lu Lin L Yang Zhen Kun ZK Hu Jian J Zhang Rui Yan RY Shen Wei Feng WF Ding Feng Hua FH Wang Xiao Qun XQ

Cardiovascular diabetology 20200904 1

<h4>Background</h4>Patients with type 2 diabetes are under substantially higher risk of in-stent restenosis (ISR) after coronary stent implantation. We sought to investigate whether visit-to-visit HbA<sub>1c</sub> variability is a potential predictor of ISR in diabetic patients after stent implantation.<h4>Methods</h4>We consecutively enrolled type 2 diabetic patients who underwent successful elective percutaneous coronary intervention and performed follow-up coronary angiography after around 12 ...[more]

PMID: 32887588

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Project description:BackgroundThis study aimed to develop and validate a nomogram to predict probability of in-stent restenosis (ISR) in patients undergoing percutaneous coronary intervention (PCI).MethodsPatients undergoing PCI with drug-eluting stents between July 2009 and August 2011 were retrieved from a cohort study in a high-volume PCI center, and further randomly assigned to training and validation sets. The least absolute shrinkage and selection operator (LASSO) regression model was used to screen out significant features for construction of nomogram. Multivariable logistic regression analysis was applied to build a nomogram-based predicting model incorporating the variables selected in the LASSO regression model. The area under the curve (AUC) of the receiver operating characteristics (ROC), calibration plot and decision curve analysis (DCA) were performed to estimate the discrimination, calibration and utility of the nomogram model respectively.ResultsA total of 463 patients with DES implantation were enrolled and randomized in the development and validation sets. The predication nomogram was constructed with five risk factors including prior PCI, hyperglycemia, stents in left anterior descending artery (LAD), stent type, and absence of clopidogrel, which proved reliable for quantifying risks of ISR for patients with stent implantation. The AUC of development and validation set were 0.706 and 0.662, respectively, indicating that the prediction model displayed moderate discrimination capacity to predict restenosis. The high quality of calibration plots in both datasets demonstrated strong concordance performance of the nomogram model. Moreover, DCA showed that the nomogram was clinically useful when intervention was decided at the possibility threshold of 9%, indicating good utility for clinical decision-making.ConclusionsThe individualized prediction nomogram incorporating 5 commonly clinical and angiographic characteristics for patients undergoing PCI can be conveniently used to facilitate early identification and improved screening of patients at higher risk of ISR.

Dataset Information

Visit-to-visit HbA1c variability is associated with in-stent restenosis in patients with type 2 diabetes after percutaneous coronary intervention.

Publications

Visit-to-visit HbA<sub>1c</sub> variability is associated with in-stent restenosis in patients with type 2 diabetes after percutaneous coronary intervention.

Similar Datasets

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