Impact of Controlling Serum Low-Density Lipoprotein Cholesterol and Triglycerides on Long-Term Clinical Outcomes in Diabetic Patients Who Have Undergone Percutaneous Coronary Intervention

Circ Rep. 2024 Nov 7;6(12):573-582. doi: 10.1253/circrep.CR-24-0081. eCollection 2024 Dec 10.

Abstract

Background: We investigated whether patients with diabetes who had good control of both low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) would be associated with better long-term clinical outcomes after percutaneous coronary intervention (PCI).

Methods and results: Using our PCI registry (Fu-Registry), the 1,006 cases with diabetes were divided into 4 groups: Group 1, LDL-C ≥100 mg/dL and TG ≥175 mg/dL; Group 2, LDL-C <100 mg/dL and TG ≥175 mg/dL; Group 3, LDL-C ≥100 mg/dL and TG <175 mg/dL; and Group 4, LDL-C <100 mg/dL and TG <175 mg/dL. The primary endpoint during the follow-up period (median follow up of 1,984 days) was defined as major adverse cardiac events (MACEs). Additionally, all coronary events were defined as a secondary endpoint. The incidence rates of MACEs were as follows: Group 1, 38%; Group 2, 26%; Group 3, 31%; and Group 4, 27% (P=0.074), and the rates tended to be higher in Group 1. All coronary events were as follows: Group 1, 66%; Group 2, 56%; Group 3, 58%; and Group 4, 51% (P=0.032).

Conclusions: In patients with diabetes who underwent PCI, the LDL-C and TG levels in Group 4 met secondary prevention targets for coronary artery disease and these patients showed better long-term clinical outcomes compared with those in other groups.

Keywords: Diabetes; Low-density lipoprotein cholesterol; Major adverse cardiac events; Percutaneous coronary intervention; Triglycerides.