Introduction: The reported rate of Diabetes Mellitus (DM) in patients undergoing Percutaneous Coronary Intervention (PCI) is 30%-40%. In 2008, the International Expert Committee recommended diabetes diagnosis by HbA1c level ≥6.5%.
Aim was to determine the prevalence of previously undiagnosed DM defined by elevated HbA1c in patients undergoing PCI and its association with 1-year clinical outcomes.
Methods: Consecutive patients undergoing PCI in Soroka University Medical Center (SUMC) were enrolled (2011-2013). HbA1c was measured before angiography. The primary outcome was 1-year Major Adverse Cardio- and Cerebrovascular Event (MACCE) defined as death, stroke, PCI or acute MI. Secondary outcomes included short term mortality.
Results: 1151 patients were enrolled (934 with ACS). DM was previously diagnosed in 391 (34%) patients, 221 (19.2%) had previously Undiagnosed DM (UDM) based on the HbA1c ≥6.5% and 539 (46.8%) did not have diabetes (Non-DM). In patients with DM HbA1c was 7.80±1.36% as compared 7.62±1.3% in patients UDM (p<0.001). UDM patients were younger (62±11) compared to DM (67.9±10) and non-DM (63.7±13), p
Conclusions: Pre–procedure HbA1c testing leads to the diagnosis of previously unknown DM in a large subgroup of patients undergoing PCI. Patients in this group have increased short and long term risk for adverse outcomes.
Our findings support routine screening for DM in all patients undergoing PCI and call for a possible intervention for DM control in a group with previously undiagnosed DM.
