Clinical Outcomes of Patients with Type II Diabetes Mellitus and Hypothyroidism undergoing Percutaneous Coronary Revascularization

Abstract

Background: Diabetes mellitus (DM) and hypothyroidism are independently associated with coronary artery disease (CAD) severity with poor percutaneous revascularization outcomes. However, the influence of Type II diabetes mellitus (T2DM) with hypothyroidism on the clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) has not been evaluated. Aim: The aim of the study is to assess the clinical outcomes of CAD patients with T2DM and hypothyroidism undergoing PCI. Materials and Methods: Consecutive patients who underwent PCI from September 2020 to March 2021 at our institution were enrolled in the study. Patients were categorized into four groups: Group I-Patients with euglycemia and euthyroid, Group II- patients with T2DM and euthyroid, Group III- patients with hypothyroidism and euglycemic, and Group IV- Patients with T2DM and hypothyroidism. Baseline demographics, laboratory investigations, procedural details, and in-hospital major adverse cardiovascular events were assessed. The continuous and normally distributed data were presented as mean ± standard deviation and were analysed using ANOVA. Categorical data were presented as the frequency with percentages and analysed using the Chi-square test. Result: In the total of 605 patients, 36% (n=220), 54% (n=325), 3% (n=19), and 7% (n=41) were in Group I, Group II, Group III, and Group IV respectively. The mean age of the population was 56.1 ± 11.6 vs 59.6 ± 9.8 vs 60.4 ± 9.9 vs 56.9 ± 12.1 (p = 0.002). Males were predominant 89.5% (n=197) in Group I and females were predominant 47.4% (n=9) in Group III. The prevalence of hypertension and dyslipidemia were high in Group II and Group IV respectively. Higher triglyceride levels (159.6 ± 109.6 Vs 166.2 ± 83.2 Vs 136.7 ± 72.3 Vs 222.2 ± 161.9, p = 0.03) and glycosylated hemoglobin A1c (HbA1C) levels (6.2 ± 1.2 Vs 8.5 ± 1.9 Vs 6.6 ± 2.1 Vs 9.2 ± 1.8, p<0.001) were noted in Group IV. Single vessel disease was high (59.1% Vs 45.5% Vs 57.8% Vs 48.7%, p=0.02) among Group I patients whereas left anterior descending (LAD) artery involvement was more in Group IV (64.5% Vs 57.8% Vs 36.8% Vs 70.7%, p=0.03) and in-stent restenosis was high among Group III (0.9% Vs 3.7% Vs 10.5%, p=0.02). Incidence of bleeding was high in Group III (0.5% Vs 1.2% Vs 10.5%, p= 0.001). There was no significant difference in In-hospital mortality between groups. Conclusion: Patients with T2DM and hypothyroidism had significantly higher levels of triglycerides, HbA1C and more LAD involvement but there was no significant difference in in- hospital mortality.