E-Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2024. Below are the accepted ones after a thorough review by our official reviewers. Don¡¯t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-004

The Association Between Free Fatty Acid and Adverse Outcomes in Patients Undergoing Percutaneous Coronary Intervention With or Without Diabetes Mellitus: A Single-Center Cohort Study.

By Qinxue Li, Jinqing Yuan

Presenter

Qinxue Li

Authors

Qinxue Li1, Jinqing Yuan1

Affiliation

Fuwai Hospital, China1
View Study Report
TCTAP A-004
High-Risk Intervention (Diabetes, Heart Failure, Renal Failure, Shock, etc)

The Association Between Free Fatty Acid and Adverse Outcomes in Patients Undergoing Percutaneous Coronary Intervention With or Without Diabetes Mellitus: A Single-Center Cohort Study.

Qinxue Li1, Jinqing Yuan1

Fuwai Hospital, China1

Background

Free fatty acids (FFA) are associated with the progression of diabetes mellitus (DM) and cardiovascular diseases. This study aimed to explore the correlation between FFA and adverse outcomes in patients with different diabetes statuses undergoing percutaneous coronary intervention (PCI).

Methods

From January to December 2013, a total of 10,724 coronary artery disease (CAD) patients underwent PCI treatment at the Fuwai Hospital. After excluding patients without FFA data, 10,424 patients were included in this study and were equally divided into 3 groups according to FFA levels. Subsequently, they were further stratified based on diabetes status. A 5-year follow-up was conducted, with the primary endpoint defined as the major adverse cardiovascular and cerebrovascular events (MACCE) and the secondary endpoints as the components of MACCE (including all-cause death, non-fatal myocardial infarction, and non-fatal stroke).

Results

In the 5-year follow-up, a total of 1,191 (11.4%) patients experienced MACCE. The FFA-M group exhibited the lowest incidence rate of MACCE. Upon further stratification based on diabetes status, KM curves revealed a significantly elevated risk of MACCE in the DM/FFA-L and DM/FFA-H groups. Multivariable Cox regression analysis confirmed similar findings, with only the DM/FFA-L and DM/FFA-H groups displaying significantly increased risks of MACCE compared to non-DM/FFA-L patients (adjusted HR: 1.375, 95% CI: 1.123-1.683, p = 0.002; adjusted HR: 1.308, 95% CI: 1.080-1.584, p = 0.006; respectively). Analysis of the secondary endpoints revealed that compared to the non-DM/FFA-L group, the DM/FFA-L and DM/FFA-H groups had a significantly higher risk of all-cause death and non-fatal stroke, while non-DM/FFA-H group patients had a significantly higher risk of all-cause death. Restricted cubic spline analysis illustrated a distinct U-shaped relationship between FFA levels and MACCE in patients with diabetes.

Conclusion

In diabetic patients undergoing PCI, both elevated and diminished levels of FFA are significantly associated with an increased risk of ischemic events. However, this relationship is attenuated in non-diabetic patients. Therefore, FFA facilitates risk assessment and the identification of high-risk individuals in patients with CAD and DM.