Relationship Between Glycosylated Hemoglobin And Cardiac Function In Elderly Patients With Type 2 Diabetes After PCI

Research background and objectiveThe prevalence of diabetes mellitus is increasing worldwide,which is driven by both population aging and an increased prevalence of overweight and obesity.Diabetes mellitus is a growing public health challenge in the world,in recent decades,the prevalence of diabetes in the Asian population has increased rapidly.Diabetes is a risk factor for coronary heart disease and heart failure.In diabetics,the leading cause of death is coronary artery disease.Although the treatment of coronary artery disease has significantly improved the survival rate,the mortality rate of diabetic patients is still higher than that of patients without diabetes.Some data support that diabetes is an important prognostic factor for death and complications in patients with coronary artery disease.Compared with non-diabetic patients,diabetic patients are older,have more cardiovascular risk factors and complications,and have more complex coronary artery disease.When acute coronary syndrome occurs,diabetic patients have a higher risk of short-and long-term prognosis.This may be due to several complications often associated with diabetes,such as obesity,high blood pressure,hyperlipidemia,and chronic kidney disease,all of which increase the risk of adverse cardiovascular events in patients.In addition,diabetes is associated with inflammation and thrombotic environments compared with non-diabetic patients.The purpose of this study was to analyze the relationship between HbA1c level and left ventricular systolic function in elderly patients with type 2 diabetes mellitus after PCI.Method1.In this study,198 elderly patients with type 2 diabetes mellitus after PCI treated in the first affiliated Hospital of Zhengzhou University from January 2017 to December 2017 were collected,including 106 females and 92 males,with an average age of（69±6）years.According to HbA_1c,there were 52 cases in group I(HbA_1c<7%)and 146 cases in II group(HbA_1c≥7%).2.The current history,past history,age,sex and the number of stents implanted and the course of diabetes were collected.Vital signs（systolic blood pressure,diastolic blood pressure,pulse,body temperature,respiratory rate）were measured for all participants;all participants were required to fast for more than 8 hours.The next morning,2 ml venous blood was collected and Fasting blood glucose（FPG）,triglyceride（TG）,total cholesterol（TC）,high density lipoprotein（HDL-C）,low density lipoprotein（LDL-C）,troponin T and brain natriuretic peptide（BNP）were measured.All selected patients after PCI were treated with American Acusin128XP/10.Color Doppler ultrasonography,left ventricular ejection fraction（LVEF）was recorded by modified Simpson method.3.Compare the clinical data and biochemical parameters of the two groups;whether LVEF is less than 50%as the dependent variable,and gender,age,FPG,diastolic blood pressure,systolic blood pressure,HbA1c,and diabetes duration as independent variables for logistic regression analysis;Spearman correlation analysis was performed with the number of stents and HbA1c,FPG,and diabetes.4.All the data were analyzed by SPSS 23.0 software.The test levelα=0.05.ResultThere were no significant differences in sex,systolic blood pressure,diastolic blood pressure,total cholesterol,high density lipoprotein,triglyceride,number of implanted stents,low density lipoprotein and troponin T between the two groups（P>0.05）.There were significant differences in age,course of diabetes,LVEF,FPG and BNP between the two groups（P<0.05）.HbA1c≥7%was a risk factor for cardiac dysfunction after PCI（OR=5.717,95%CI 1.549²1.101）.There was no correlation between the number of implanted stents and the course of HbA1c,FPG and diabetes mellitus（P>0.05）.ConclusionHbA_1c≥7%is a risk factor for abnormal cardiac function in elderly patients with type 2 diabetes mellitus after PCI.