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Cardiovascular prognosis in patients with type 2 diabetes mellitus mediated by the functional completeness after revascularization
Background: Functional complete revascularization (CR) after percutaneous coronary intervention (PCI), as assessed by the residual functional SYNTAX score (rFSS), has been correlated with enhanced prognostic outcomes.
Methods: A total of 1,555 patients with available post-PCI quantitative flow ratio (QFR) were included, whose data were collected from PANDA III trial. Functional CR was defined as rFSS=0, while anatomic CR was defined as residual SYNTAX score (rSS) = 0. Structural equation modeling was used to analysis whether functional CR explained the relationship between T2DM (Type 2 diabetes mellitus) and the risk of 2-year rates of major adverse cardiac events (including all-cause death, all myocardial infarction, or any ischemia-driven revascularization).
Results: Multiple cox regression revealed that T2DM was associated with MACE (P=0.007), but not after adding functional CR to the model (P=0.05), s uggesting a mediation effect. Structural equation modeling analysis revealed a significant indirect effect of T2DM on MACE through functional CR (P=0.006, Mediated [%] = 27.3), suggesting a partial mediation effect.
Conclusion: The degree of functional revascularization may emerge as a central mechanism pivotal in elucidating the association between T2DM and the risk of MACE. Cardiologists should prioritize functional complete revascularization during the initial PCI procedure for patients with diabetes mellitus. © 2024 Elsevier B.V.
Authors : Zheng Z.; Zhang R.; Shi S.; He J.; Feng L.; Guan C.; Song L.; Zhu C.; Yin D.; Li J.; Dou K.
Source : Elsevier Ireland Ltd
Article Information
| Year | 2024 |
| Type | Article |
| DOI | 10.1016/j.diabres.2024.111866 |
| ISSN | 01688227 |
| Volume | 217 |
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