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1Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
3Department of Biostatistics, Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea
Copyright © 2021 Korean Endocrine Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST
ChongKunDang Pharmaceutical Company, Seoul, Republic of Korea provided financial support for this study.
AUTHOR CONTRIBUTIONS
Conception or design: I.J. Acquisition, analysis, or interpretation of data: H.K., S.E.P., K.D.H., Y.G.P. Drafting the work or revising: I.J., H.K., S.E.P., E.J.R., W.Y.L. Final approval of the manuscript: I.J., H.K., S.E.P., K.D.H., Y.G.P., E.J.R., W.Y.L.
Values are expressed as mean±standard deviation, number (%), or median (interquartile range).
PCI, percutaneous coronary intervention; TZD, thiazolidinedione; DPP4, dipeptidyl peptidase-4; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; LDL-C, low density lipoprotein cholesterol; TG, triglyceride.
Number | Repeat PCI | Duration | IR, /1,000 PY | HR (95% CI) | |||||
---|---|---|---|---|---|---|---|---|---|
|
|||||||||
Model 1a | Model 2b | Model 3c | Model 4d | Model 5e | |||||
Insulin | |||||||||
No | 20,904 | 2,440 | 91,387.63 | 26.7 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 14,444 | 2,005 | 59,743.13 | 33.6 | 1.25 (1.18–1.33) | 1.24 (1.16–1.31) | 1.23 (1.15–1.30) | 1.21 (1.14–1.29) | 1.15 (1.08–1.22) |
|
|||||||||
Sulfonylurea | |||||||||
No | 14,342 | 1,700 | 60,835.35 | 27.9 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 21,006 | 2,745 | 90,295.41 | 30.4 | 1.11 (1.04–1.17) | 1.10 (1.04–1.17) | 1.07 (0.99–1.17) | 1.07 (0.98–1.16) | 1.04 (0.96–1.13) |
|
|||||||||
Metformin | |||||||||
No | 8,457 | 1,131 | 35,535.41 | 31.8 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 26,891 | 3,314 | 115,595.36 | 28.7 | 0.90 (0.84–0.96) | 0.90 (0.85–0.97) | 0.74 (0.68–0.82) | 0.75 (0.68–0.82) | 0.77 (0.70–0.85) |
|
|||||||||
Meglitinides | |||||||||
No | 33,722 | 4,175 | 144,400.00 | 28.9 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 1,626 | 270 | 6,730.76 | 40.1 | 1.40 (1.24–1.59) | 1.38 (1.22–1.56) | 1.28 (1.13–1.45) | 1.28 (1.13–1.45) | 1.27 (1.12–1.44) |
|
|||||||||
TZD | |||||||||
No | 33,552 | 4,232 | 143,495.12 | 29.5 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 1,796 | 213 | 7,635.64 | 27.9 | 0.94 (0.82–1.08) | 0.95 (0.83–1.09) | 0.92 (0.80–1.06) | 0.92 (0.80–1.06) | 0.90 (0.78–1.04) |
|
|||||||||
DPP4i | |||||||||
No | 22,849 | 2,924 | 100,675.21 | 29.0 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 12,499 | 1,521 | 50,455.56 | 30.1 | 0.98 (0.92–1.05) | 0.98 (0.92–1.05) | 0.93 (0.86–0.99) | 0.93 (0.86–1.00) | 0.93 (0.87–1.01) |
|
|||||||||
AGI | |||||||||
No | 29,851 | 3,590 | 126,461.18 | 28.4 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 5,497 | 855 | 24,669.59 | 34.7 | 1.28 (1.19–1.38) | 1.28 (1.19–1.38) | 1.25 (1.15–1.36) | 1.25 (1.15–1.36) | 1.24 (1.14–1.34) |
The incidence rate is presented per 1,000 person-years (PY).
PCI, percutaneous coronary intervention; IR, incidence rate; HR, hazard ratio; CI, confidence interval; TZD, thiazolidinedione; DPP4i, dipeptidyl peptidase-4 inhibitor; AGI, alpha-glucosidase inhibitor.
a Adjusted for age and sex;
b Adjusted model 1+adjusted for household income, hypertension, dyslipidemia, current smoking, alcohol, regular exercise, and body mass index;
c Adjusted model 2+adjusted for use of insulin, number of oral antidiabetic drugs;
d Adjusted model 3+adjusted for fasting blood glucose;
e Adjusted model 4+adjusted for duration of diabetes.
The incidence rate is presented per 1,000 person-years (PY).
Values are expressed as hazard ratio (95% confidence interval). Model 1: Unadjusted; Model 2: Adjusted for household income, hypertension, dyslipidemia, current smoking, alcohol, regular exercise, BMI, use of insulin, number of oral antidiabetic drugs, fasting blood glucose, and duration of diabetes.
PCI, percutaneous coronary intervention; IR, incidence rate; BMI, body mass index; TZD, thiazolidinedione; DPP4i, dipeptidyl peptidase-4 inhibitor; AGI, alpha-glucosidase inhibitor.
The incidence rate is presented per 1,000 person-years (PY).
Values are expressed as hazard ratio (95% confidence interval). Model 1: Unadjusted; Model 2: Adjusted for age, sex, household income, hypertension, dyslipidemia, current smoking, alcohol, regular exercise, BMI, use of insulin, and number of oral antidiabetic drugs.
PCI, percutaneous coronary intervention; IR, incidence rate; BMI, body mass index.
Characteristic | Total | Repeat PCI | ||
---|---|---|---|---|
| ||||
No | Yes | P value | ||
Number | 35,348 | 30,903 | 4,445 | |
| ||||
Age, yr | 64.6±9.52 | 64.7±9.56 | 64.0±9.22 | <0.0001 |
| ||||
Male sex | 23,991 (67.9) | 20,900 (67.6) | 3,091 (69.5) | 0.0109 |
| ||||
Household income, low 20% | 7,580 (21.4) | 6,570 (21.3) | 1,010 (22.7) | 0.0264 |
| ||||
Smoking status | 0.2052 | |||
Never smoker | 18,113 (51.2) | 15,853 (51.3) | 2,260 (50.8) | |
Former smoker | 9,580 (27.1) | 8,329 (27.0) | 1,251 (28.1) | |
Current smoker | 7,655 (21.7) | 6,721 (21.8) | 934 (21.0) | |
| ||||
Alcohol drinking | 0.2101 | |||
None | 25,171 (71.2) | 21,961 (71.1) | 3,210 (72.2) | |
Mild (<30 g/day) | 8,380 (23.7) | 7,373 (23.9) | 1,007 (22.7) | |
Heavy (≥30 g/day) | 1,797 (5.1) | 1,569 (5.1) | 228 (5.1) | |
| ||||
Regular exercise | 7,578 (21.4) | 6,665 (21.6) | 913 (20.5) | 0.1186 |
| ||||
Use of insulin | 14,444 (40.9) | 12,439 (40.3) | 2,005 (45.1) | <0.0001 |
| ||||
Sulfonylurea | 21,006 (59.4) | 18,261 (59.1) | 2,745 (61.8) | 0.0007 |
| ||||
Metformin | 26,891 (76.1) | 23,577 (76.3) | 3,314 (74.6) | 0.0111 |
| ||||
Meglitinide | 1,626 (4.6) | 1,356 (4.4) | 270 (6.1) | <0.0001 |
| ||||
TZD | 1,796 (5.1) | 1,583 (5.1) | 213 (4.8) | 0.3480 |
| ||||
DPP4 inhibitor | 12,499 (35.4) | 10,978 (35.5) | 1,521 (34.2) | 0.0886 |
| ||||
Alpha-glucosidase inhibitor | 5,497 (15.6) | 4,642 (15.0) | 855 (19.2) | <0.0001 |
| ||||
No. of antidiabetic agents | 0.0633 | |||
0 | 4,723 (13.4) | 4,161 (13.5) | 562 (12.6) | |
1 | 6,738 (19.1) | 5,922 (19.2) | 816 (18.4) | |
2 | 11,919 (33.7) | 10,429 (33.8) | 1,490 (33.5) | |
≥3 | 11,968 (33.9) | 10,391 (33.6) | 1,577 (35.5) | |
| ||||
Hypertension | 31,579 (89.3) | 27,552 (89.2) | 4,027 (90.6) | 0.0036 |
| ||||
Dyslipidemia | 31,932 (90.3) | 27,953 (90.5) | 3,979 (89.5) | 0.0479 |
| ||||
Chronic kidney disease | 7,771 (22.0) | 6,658 (21.5) | 1,113 (25.0) | <0.0001 |
| ||||
BMI, kg/m2 | 25.0±3.06 | 25.0±3.05 | 25.1±3.07 | 0.0374 |
| ||||
SBP, mm Hg | 129.5±16.59 | 129.4±16.56 | 130.0±16.83 | 0.0177 |
| ||||
DBP, mm Hg | 77.4±10.43 | 77.4±10.42 | 77.2±10.53 | 0.2120 |
| ||||
Total cholesterol, mg/dL | 175.4±47.2 | 175.2±47.15 | 176.8±47.49 | 0.0405 |
| ||||
Fasting blood glucose, mg/dL | 138.7±45.86 | 138.3±45.42 | 141.3±48.74 | <0.0001 |
| ||||
Waist circumference, cm | 86.7±8.06 | 86.6±8.05 | 87.0±8.07 | 0.0009 |
| ||||
Weight, kg | 65.7±10.87 | 65.7±10.89 | 66.2±10.7 | 0.0057 |
| ||||
LDL-C, mg/dL | 97.6±43.79 | 97.4±43.81 | 98.6±43.64 | 0.0827 |
| ||||
TG, mg/dL | 138.8 (138.1–139.6) | 138.5 (137.7–139.3) | 141.2 (139.0–143.4) | 0.0210 |
Number | Repeat PCI | Duration | IR, /1,000 PY | HR (95% CI) | |||||
---|---|---|---|---|---|---|---|---|---|
| |||||||||
Model 1 |
Model 2 |
Model 3 |
Model 4 |
Model 5 | |||||
Insulin | |||||||||
No | 20,904 | 2,440 | 91,387.63 | 26.7 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 14,444 | 2,005 | 59,743.13 | 33.6 | 1.25 (1.18–1.33) | 1.24 (1.16–1.31) | 1.23 (1.15–1.30) | 1.21 (1.14–1.29) | 1.15 (1.08–1.22) |
| |||||||||
Sulfonylurea | |||||||||
No | 14,342 | 1,700 | 60,835.35 | 27.9 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 21,006 | 2,745 | 90,295.41 | 30.4 | 1.11 (1.04–1.17) | 1.10 (1.04–1.17) | 1.07 (0.99–1.17) | 1.07 (0.98–1.16) | 1.04 (0.96–1.13) |
| |||||||||
Metformin | |||||||||
No | 8,457 | 1,131 | 35,535.41 | 31.8 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 26,891 | 3,314 | 115,595.36 | 28.7 | 0.90 (0.84–0.96) | 0.90 (0.85–0.97) | 0.74 (0.68–0.82) | 0.75 (0.68–0.82) | 0.77 (0.70–0.85) |
| |||||||||
Meglitinides | |||||||||
No | 33,722 | 4,175 | 144,400.00 | 28.9 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 1,626 | 270 | 6,730.76 | 40.1 | 1.40 (1.24–1.59) | 1.38 (1.22–1.56) | 1.28 (1.13–1.45) | 1.28 (1.13–1.45) | 1.27 (1.12–1.44) |
| |||||||||
TZD | |||||||||
No | 33,552 | 4,232 | 143,495.12 | 29.5 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 1,796 | 213 | 7,635.64 | 27.9 | 0.94 (0.82–1.08) | 0.95 (0.83–1.09) | 0.92 (0.80–1.06) | 0.92 (0.80–1.06) | 0.90 (0.78–1.04) |
| |||||||||
DPP4i | |||||||||
No | 22,849 | 2,924 | 100,675.21 | 29.0 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 12,499 | 1,521 | 50,455.56 | 30.1 | 0.98 (0.92–1.05) | 0.98 (0.92–1.05) | 0.93 (0.86–0.99) | 0.93 (0.86–1.00) | 0.93 (0.87–1.01) |
| |||||||||
AGI | |||||||||
No | 29,851 | 3,590 | 126,461.18 | 28.4 | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
Yes | 5,497 | 855 | 24,669.59 | 34.7 | 1.28 (1.19–1.38) | 1.28 (1.19–1.38) | 1.25 (1.15–1.36) | 1.25 (1.15–1.36) | 1.24 (1.14–1.34) |
Number | Repeat PCI | Duration | IR, /1,000 PY | Model 1 | P for interaction | Model 2 | P for interaction | |
---|---|---|---|---|---|---|---|---|
BMI <25 kg/m2 | ||||||||
Insulin | ||||||||
No | 10,603 | 1,240 | 45,748.36 | 27.1 | 1 (reference) | 0.1571 | 1 (reference) | 0.1710 |
Yes | 8,096 | 1,084 | 33,123.32 | 32.7 | 1.19 (1.10–1.29) | 1.09 (1.00–1.19) | ||
Sulfonylurea | ||||||||
No | 7,401 | 847 | 30,927.41 | 27.4 | 1 (reference) | 0.2569 | 1 (reference) | 0.2875 |
Yes | 11,298 | 1,477 | 47,944.27 | 30.8 | 1.14 (1.05–1.24) | 1.03 (0.92–1.16) | ||
Metformin | ||||||||
No | 4,397 | 568 | 18,102.88 | 31.4 | 1 (reference) | 0.4407 | 1 (reference) | 0.4181 |
Yes | 14,302 | 1,756 | 60,768.8 | 28.9 | 0.93 (0.84–1.02) | 0.75 (0.66–0.86) | ||
Meglitinides | ||||||||
No | 17,725 | 2,164 | 74,917.41 | 28.9 | 1 (reference) | 0.8760 | 1 (reference) | 0.8469 |
Yes | 974 | 160 | 3,954.27 | 40.5 | 1.41 (1.20–1.65) | 1.28 (1.09–1.51) | ||
TZD | ||||||||
No | 17,822 | 2,206 | 75,248.53 | 29.3 | 1 (reference) | 0.0216 | 1 (reference) | 0.0139 |
Yes | 877 | 118 | 3,623.15 | 32.6 | 1.11 (0.92–1.33) | 1.05 (0.87–1.26) | ||
DPP4i | ||||||||
No | 11,945 | 1,500 | 51,987.36 | 28.9 | 1 (reference) | 0.4574 | 1 (reference) | 0.5158 |
Yes | 6,754 | 824 | 26,884.32 | 30.6 | 1.01 (0.93–1.10) | 0.92 (0.83–1.02) | ||
AGI | ||||||||
No | 15,409 | 1,818 | 64,369.28 | 28.2 | 1 (reference) | 0.7990 | 1 (reference) | 0.7794 |
Yes | 3,290 | 506 | 14,502.40 | 34.9 | 1.29 (1.17–1.42) | 1.23 (1.10–1.37) | ||
| ||||||||
BMI ≥25 kg/m2 | ||||||||
Insulin | ||||||||
No | 10,301 | 1,200 | 45,639.27 | 26.3 | 1 (reference) | 0.1571 | 1 (reference) | 0.1710 |
Yes | 6,348 | 921 | 26,619.82 | 34.6 | 1.30 (1.19–1.41) | 1.21 (1.11–1.33) | ||
Sulfonylurea | ||||||||
No | 6,941 | 853 | 29,907.94 | 28.5 | 1 (reference) | 0.2569 | 1 (reference) | 0.2875 |
Yes | 9,708 | 1,268 | 42,351.14 | 29.9 | 1.06 (0.97–1.16) | 1.04 (0.93–1.18) | ||
Metformin | ||||||||
No | 4,060 | 563 | 17,432.53 | 32.3 | 1 (reference) | 0.4407 | 1 (reference) | 0.4181 |
Yes | 12,589 | 1,558 | 54,826.55 | 28.4 | 0.88 (0.80–0.97) | 0.79 (0.69–0.91) | ||
Meglitinides | ||||||||
No | 15,997 | 2,011 | 69,482.59 | 28.9 | 1 (reference) | 0.8760 | 1 (reference) | 0.8469 |
Yes | 652 | 110 | 2,776.49 | 39.6 | 1.38 (1.14–1.67) | 1.24 (1.02–1.51) | ||
TZD | ||||||||
No | 15,730 | 2,026 | 68,246.6 | 29.7 | 1 (reference) | 0.0216 | 1 (reference) | 0.0139 |
Yes | 919 | 95 | 4,012.49 | 23.7 | 0.80 (0.65–0.98) | 0.77 (0.63–0.95) | ||
DPP4i | ||||||||
No | 10,904 | 1,424 | 48,687.84 | 29.2 | 1 (reference) | 0.4574 | 1 (reference) | 0.5158 |
Yes | 5,745 | 697 | 23,571.24 | 29.6 | 0.96 (0.88–1.06) | 0.95 (0.85–1.07) | ||
AGI | ||||||||
No | 14,442 | 1,772 | 62,091.90 | 28.5 | 1 (reference) | 0.7990 | 1 (reference) | 0.7794 |
Yes | 2,207 | 349 | 10,167.19 | 34.3 | 1.26 (1.12–1.41) | 1.25 (1.10–1.41) |
Number | Repeat PCI | Duration | IR, /1,000 PY | Model 1 | P for interaction | Model 2 | P for interaction | |
---|---|---|---|---|---|---|---|---|
BMI <25 kg/m2 | ||||||||
No. of oral antidiabetic drugs | ||||||||
0 | 2,398 | 263 | 9,956.05 | 26.4 | 1 (reference) | 0.0944 | 1 (reference) | 0.0848 |
1 | 3,461 | 397 | 14,770.92 | 26.9 | 1.03 (0.88–1.20) | 1.02 (0.88–1.20) | ||
2 | 6,180 | 791 | 26,499.35 | 29.85 | 1.15 (1.00–1.32) | 1.13 (0.98–1.30) | ||
≥3 | 6,660 | 873 | 27,645.37 | 31.6 | 1.19 (1.04–1.37) | 1.16 (1.01–1.33) | ||
| ||||||||
BMI ≥25 kg/m2 | ||||||||
No. of oral antidiabetic drugs | ||||||||
0 | 2,325 | 299 | 9,973.99 | 30.0 | 1 (reference) | 0.0944 | 1 (reference) | 0.0848 |
1 | 3,277 | 419 | 14,295.87 | 29.3 | 0.98 (0.85–1.14) | 0.97 (0.83–1.12) | ||
2 | 5,739 | 699 | 25,450.78 | 27.5 | 0.93 (0.81–1.06) | 0.90 (0.78–1.03) | ||
≥3 | 5,308 | 704 | 22,538.44 | 31.2 | 1.03 (0.90–1.18) | 0.98 (0.85–1.12) |
Values are expressed as mean±standard deviation, number (%), or median (interquartile range). PCI, percutaneous coronary intervention; TZD, thiazolidinedione; DPP4, dipeptidyl peptidase-4; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; LDL-C, low density lipoprotein cholesterol; TG, triglyceride.
The incidence rate is presented per 1,000 person-years (PY). PCI, percutaneous coronary intervention; IR, incidence rate; HR, hazard ratio; CI, confidence interval; TZD, thiazolidinedione; DPP4i, dipeptidyl peptidase-4 inhibitor; AGI, alpha-glucosidase inhibitor. Adjusted for age and sex; Adjusted model 1+adjusted for household income, hypertension, dyslipidemia, current smoking, alcohol, regular exercise, and body mass index; Adjusted model 2+adjusted for use of insulin, number of oral antidiabetic drugs; Adjusted model 3+adjusted for fasting blood glucose; Adjusted model 4+adjusted for duration of diabetes.
The incidence rate is presented per 1,000 person-years (PY). Values are expressed as hazard ratio (95% confidence interval). Model 1: Unadjusted; Model 2: Adjusted for household income, hypertension, dyslipidemia, current smoking, alcohol, regular exercise, BMI, use of insulin, number of oral antidiabetic drugs, fasting blood glucose, and duration of diabetes. PCI, percutaneous coronary intervention; IR, incidence rate; BMI, body mass index; TZD, thiazolidinedione; DPP4i, dipeptidyl peptidase-4 inhibitor; AGI, alpha-glucosidase inhibitor.
The incidence rate is presented per 1,000 person-years (PY). Values are expressed as hazard ratio (95% confidence interval). Model 1: Unadjusted; Model 2: Adjusted for age, sex, household income, hypertension, dyslipidemia, current smoking, alcohol, regular exercise, BMI, use of insulin, and number of oral antidiabetic drugs. PCI, percutaneous coronary intervention; IR, incidence rate; BMI, body mass index.