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Lower 1,5-anhydroglucitol is associated with adverse clinical events after percutaneous coronary intervention
Authors:Takayuki Fujiwara  Masashi Yoshida  Naoyuki Akashi  Hodaka Yamada  Takunori Tsukui  Tomohiro Nakamura  Kenichi Sakakura  Hiroshi Wada  Kenshiro Arao  Takuji Katayama  Tomio Umemoto  Hiroshi Funayama  Yoshitaka Sugawara  Takeshi Mitsuhashi  Masafumi Kakei  Shin-ichi Momomura  Junya Ako
Institution:1.Department of Cardiovascular Medicine, Saitama Medical Center,Jichi Medical University,Saitama,Japan;2.Department of Endocrinology and Metabolism, Saitama Medical Center,Jichi Medical University,Saitama,Japan;3.Department of Cardiovascular Medicine,Kitasato University,Sagamihara,Japan
Abstract:Diabetes mellitus and impaired glucose tolerance are well-known risk factors for coronary artery disease (CAD) and adverse clinical events after percutaneous coronary intervention (PCI). Postprandial hyperglycemia is an important risk factor for CAD and serum 1,5-anhydroglucitol (1,5-AG) reflects postprandial hyperglycemia more robustly than hemoglobin (Hb)A1c. We aimed to clarify the relationship between serum 1,5-AG level and adverse clinical events after PCI. We enrolled 141 patients after PCI with follow-up coronary angiography. We evaluated associations between glycemic biomarkers including HbA1c and 1,5-AG and cardiovascular events during follow-up. Median serum 1,5-AG level was significantly lower in patients with any coronary revascularization and target lesion revascularization (TLR) 13.4 µg/ml (first quartile, third quartile 9.80, 18.3) vs. 18.7 (12.8, 24.2), p = 0.005; 13.4 µg/ml (10.2, 16.4) vs. 18.7 (12.9, 24.2), p = 0.001, respectively]. Multivariate logistic analysis showed lower 1,5-AG was independently associated with any coronary revascularization and TLR (odds ratio 0.93, 95 % confidence interval 0.86–0.99, p = 0.04; 0.90, 0.81–0.99, p = 0.044, respectively), whereas higher HbA1c was not. Postprandial hyperglycemia and lower 1,5-AG are important risk factors for adverse clinical events after PCI.
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