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Even though most of the post- percutaneous coronary intervention (PCI) patients had been managed with good control of blood lipid in accordance with current guidelines, some of them still had to receive PCI once again. The study was conducted to describe the prevalence of secondary PCI and further investigate HbA1c as well as other factors highly associated with secondary events among post-PCI patients in Shanghai.
All of the 7504 CHD patients hospitalized at Shanghai Eastern Hospital Affiliated to Tongji University between November 11, 2011 and March 31, 2015 were obtained. In this study, adults underwent PCI were included. 4946 underwent PCI for the first time and 599 underwent PCI once again. Lesion number and appropriate revascularization strategies were measured with coronary angiography. Binary logistic regression analysis was implemented to evaluate the associations of secondary PCI with risk factors.
The standardized prevalence of secondary PCI was 10.80% in total patients, 11.30% in SCAD patients and 10.52% in ACS patients. In the multivariable-adjusted regression models, there were no significant associations between patients with or without secondary PCI and LDL-C. However, the risk of secondary PCI (OR= 1.10, 95%CI: 1.02 to 1.20, p=0.02) was significantly associated with higher HbA1c adjusted for potential confounders. HbA1c was also categorized according to the current guidelines, which showed that HbA1c 5.7- 6.5% had greater adds for risk of secondary PCI (OR= 1.33, 95%CI: 1.04- 1.69, p< 0.001), and the same with HbA1c ≥6.5% (OR= 2.43, 95%CI: 1.81- 3.25, p< 0.001) compared with the reference group (HbA1c ≤ 5.7 %). Additionally, similar patterns were observed in ACS patients (HbA1c 5.7- 6.5%: OR= 1.32, 95%CI: 1.04- 1.69, p< 0.001; HbA1c ≥6.5%: OR= 2.42, 95%CI: 1.81- 3.24, p< 0.001) as well as many other subgroups (all P<0.05). Females and patients never smoking were at lower risk of secondary PCI.
Prevalence of secondary PCI was still high when post- PCI patients managed the treatment target of LDL-C. With HbA1c increased, patients are more likely to undergo PCI once again.