CATHEDRAL: Correlation Between Targeted HbA1c Values and Prevention of Recurrent Cardiovascular Events in Type 2 Diabetes After PCI

Sponsor

Shanghai 10th People's Hospital (Other)

Overall Status

Recruiting

CT.gov ID

NCT05134129

Collaborator

(none)

1,500

Enrollment

Location

40.2

Anticipated Duration (Months)

37.3

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Diabetes is a leading social and economic burden in the world. It is the main reason of macrovascular disease incidence and mortality. Prospective studies have demonstrated that high glycosylated hemoglobin (HbA1C) levels are associated with an increased risk of cardiovascular events in a population of diabetic patients without a history of coronary artery disease. Further, the predictive value of high preprocedural glycemia levels has been reported in diabetic patients undergoing percutaneous coronary intervention (PCI). The aim of the present study was to assess the predictive value of preprocedural HbA1C levels for cardiovascular complications in a large population of diabetic patients undergoing PCI with stent implantation. Glycosylated hemoglobin (HbA1c) reflects the average blood sugar level in the past 2-3 months. As glycosylated hemoglobin has been clinically tested and standardized internationally, increasing evidence is recommended for routine monitoring in diabetes care. The American Diabetes Association (ADA) suggested that in the treatment of diabetes, blood sugar control should control HbA1c level below 6.5%. Although，there is evidence that controlling blood glucose can reduce the incidence of microvascular complications, in the past three trials, intensive glycemic control did not significantly reduce adverse CV events in patients with onger duration of diabetes.Therefore, most primary and secondary prevention guidelines recommend HbA1c below 6.5% or 7% to prevent adverse cardiovascular outcomes in patients with diabetes mellitus. The optimal target level of glycosylated hemoglobin is still hotly debated. In addition, there is still lack of evidence for the level of HbA1c in patients with major vascular disease history in secondary prevention of recurrence cardiovascular events.

Therefore, to explore and determine the optimal level of blood glucose control is the focus of controversy in preventing recurrence cardiovascular events in diabetic patients. Investigator will combine epidemiology and metabolomics to study the effect of glycosylated hemoglobin on secondary cardiovascular events, and further determine whether to strengthen hypoglycemic treatment after PCI.

Condition or Disease	Intervention/Treatment	Phase
Diabetes Mellitus Percutaneous Coronary Intervention

Detailed Description

This is a longitudinal cohort study including retrospective study, prospective study and nested case-control study.The first cross-sectional survey was conducted in 2021.

Study Design

Study Type:

Observational

Anticipated Enrollment :

1500 participants

Observational Model:

Cohort

Time Perspective:

Prospective

Official Title:

Correlation Between Targeted Hemoglobin A1C Levels and Prevention of Recurrent Cardiovascular Events in Type 2 Diabetes After Coronary Intervention

Actual Study Start Date :

Apr 25, 2021

Anticipated Primary Completion Date :

Sep 1, 2024

Anticipated Study Completion Date :

Sep 1, 2024

Outcome Measures

Primary Outcome Measures

Coronary revascularization [3 years]
Coronary revascularization includes percutaneous coronary intervention, or/and percutaneous coronary artery dilatation, or/and percutaneous coronary artery bypass grafting.
All cause mortality [3 years]
which refers to the total death caused by various causes in a certain period.
Cardiac mortality [3 years]
Cardiac death refers to the death caused by serious cardiac dysfunction or failure caused by heart disease or injury in a certain period.
Differential polar compound [3 years]
Metabonomic analysis uses non targeted detection methods to detect polar compounds in blood. The characteristic peaks of detectable substances were detected by chromatographic Series platform, and then these characteristic peaks were compared with the standard library containing more than 8000 metabolites, annotated the compounds, and screened out the different metabolites between groups.
Differential lipid compounds [3 years]
Metabonomic analysis uses non targeted detection methods to detect lipid compounds in blood. The characteristic peaks of detectable substances were detected by chromatographic Series platform, and then these characteristic peaks were compared with the standard library containing more than 8000 metabolites, annotated the compounds, and screened out the different metabolites between groups.

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years and Older

Sexes Eligible for Study:

All

Inclusion Criteria:

1. Age ≥ 18, male or female;

all patients with diabetes combined with PCI operation;

Exclusion Criteria:

1. Less than 18 years old

Pregnancy
Patients with preoperative glycosylated hemoglobin index deficiency
Chronic maintenance hemodialysis patients

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Department of Cardiology,Shanghai Tenth People's Hospital	Shanghai		China	200072

Sponsors and Collaborators

Shanghai 10th People's Hospital

Investigators

Principal Investigator: Yan Cang, MD, Department of Cardiology, Shanghai Tenth People's Hospital
Principal Investigator: Zheng Liu, pHD, Department of Cardiology, Shanghai Tenth People's Hospital
Principal Investigator: Zhicai Wang, MD, Department of Cardiology, Shanghai Tenth People's Hospital