부산대학교 도서관

Objectives: Statins for the prevention of CVD are known to be as diabetogenic. However most clinical trials suggested that current statin therapy in moderate to high cardiovascular risk should not be changed, due to the outwheighing benefits of statins on CVD prevention. We investigated which clinical variables on treatment are most closely associated with the development of 24 month MACE (all death, any myocardial infarction and target vessel revascularization) in DES implanted patients on statin therapy. Methods: Total 299 patients undergone DES implantation with taking statins for secondary prevention were involved. Tracking the development of MACE within 24 month post-PCI, 12 month follow up clinical variables showing significant correlation to the event were evaluated. To discover whether the changes in clinical parameters over the 12 month follow up are associated with the event development, subtractions from baseline to follow up lab results and absolute value conversion of the subtractions are obtained. Variables showing significant difference between the groups were put into the multivariate analysis and into the survival curve model. Results: Fasting glucose at 12 month were significantly higher in the event group. Subtractions from baseline to 12 month follow up showed no significant differences between the groups, however, absolute change in fasting glucose revealed a significant difference. In multivariate analysis, absolute change in fasting glucose greater than 17 mg/dL/year was strongly associated with the event development. When study population was further divided into four groups by using IQR of absolute change in fasting glucose, greater absolute change during 12 month post-PCI showed a higher risk of 24 month MACE development in both multivariate analysis and survival curve models. Conclusion: The findings suggest that greater absolute change in fasting glucose during 12 month post-PCI is an independent risk factor for 24 month MACE development in DES implanted patients on statin therapy. Relative glucose control impairment described as absolute change in fasting glucose in the current study might be responsible for the development of 24 month MACE.