Outcomes of Prediabetes Compared with Normoglycaemia and Diabetes Mellitus in Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis
Authors: Ahsan Muhammad Junaid ,   MercyOne Iowa Heart Center, Des Moines, IA, USA, Latif Azka ,   Baylor University Medical Center, Houston, TX, USA, Ahmad Soban ,   East Carolina University, Greenville, NC, USA, Willman Claire ,   Creighton University, Omaha, NE, USA, Lateef Noman ,   University of Nebraska Medical Center, Omaha, NE, USA, Shabbir Muhammad Asim ,   University of Nebraska Medical Center, Omaha, NE, USA, Ahsan Mohammad Zoraiz ,   Fatima Memorial Hospital, Lahore, Pakistan, Yousaf Amman ,   Michigan State University, McLaren Flint, MI, USA, Riasa Maria ,   Mount Sinai Beth Israel, Manhattan, NY, USA, Ghali Magdi ,   MercyOne Iowa Heart Center, Des Moines, IA, USA, Siller-Matula Jolanta ,   Medical University of Vienna, Vienna, Austria,   Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Center for Preclinical Research and Technology, Warsaw, Poland, Gwon Yeongjin ,   University of Nebraska Medical Center, Omaha, NE, USA, Mamas Mamas A ,   Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, UK, Brilakis Emmanouil S ,   Minneapolis Heart Institute, Minneapolis, MN, USA, Abbott J Dawn ,   Brown University, Providence, RI, USA, Bhatt Deepak L ,   Icahn School of Medicine, Mount Sinai Heart, New York, NY, USA, Velagapudi Poonam ,   University of Nebraska Medical Center, Omaha, NE, USA
Published: July 2023

Background: Patients with prediabetes are at increased risk of coronary artery disease (CAD). However, the association between prediabetes and adverse clinical outcomes following percutaneous coronary intervention (PCI) is inconsistent, in contrast to outcomes in patients with diabetes mellitus (DM). Thus, this meta-analysis evaluated the impact of dysglycaemia on PCI outcomes. Methods: The PubMed, Embase, Cochrane, and ClinicalTrials. gov databases were systematically reviewed from inception of databases until June 2022. In 17 studies, outcomes of PCI in patients with prediabetes were compared with patients who were normoglycaemic, and patients with DM. The primary outcome was all-cause mortality at the longest follow-up. Results: Included were 12 prospective and five retrospective studies, with 11,868, 14,894 and 13,536 patients undergoing PCI in the prediabetes, normoglycaemic and DM groups, respectively. Normoglycaemic patients had a statistically lower risk of all-cause mortality, (risk ratio [RR] 0.66, 95% confidence interval [CI] 0.52–0.84), myocardial infarction (MI; RR 0.76, 95% CI 0.61–0.95) and cardiac mortality (RR 0.58, 95% CI 0.39–0.87) compared with prediabetic patients undergoing PCI at the longest follow-up. Patients with prediabetes had a lower risk of all-cause mortality (RR=0.72 [95% CI 0.53–0.97]) and cardiac mortality (RR =0.47 [95% CI 0.23–0.93]) compared with patients with DM who underwent PCI. Conclusion: Among patients who underwent PCI for CAD, the risk of all-cause and cardiac mortality, major adverse cardiovascular events and MI in prediabetic patients was higher compared with normoglycaemic patients but lower compared with patients with DM.