Hemoglobin A1c association patterns with cardiovascular outcomes among patients with diabetes mellitus following percutaneous coronary intervention: a systematic review

Tariq, Ayesha and Bhatti, Zohra and Chaudary, Muhammad Nabeel Akbar and Laghari, Madeeha and Khan, Amer Hayat and Mohamed Nazar, Nor Ilyani and Talpur, Bandeh Ali (2026) Hemoglobin A1c association patterns with cardiovascular outcomes among patients with diabetes mellitus following percutaneous coronary intervention: a systematic review. Diabetes & Vascular Disease Research, 23 (3). pp. 1-11. ISSN 1479-1641 E-ISSN 1752-8984

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Abstract

Abstract Background: Cardiovascular complications are the leading cause of mortality in patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI). This systematic review aims to evaluate the association between HbA1c levels and major adverse cardiovascular events (MACE) in patients with DM post-PCI. Methods: A comprehensive literature search was conducted following PRISMA guidelines. Eligible studies included randomized controlled trials, cohort studies, and observational analyses assessing the impact of strict, moderate, and poor glycaemic control on cardiovascular outcomes. Data extraction focused on HbA1c levels, MACE incidence, cardiovascular mortality, and cardiovascular complications. Results: Nine studies with 24,978 participants were included. U-shaped and J-shaped relationships were found between HbA1c levels and cardiovascular outcomes. Moderate glycaemic control (HbA1c 6.5%–7.5%) was associated with the lowest risk of MACE and mortality. In contrast, strict glycaemic control (HbA1c <6.5%) and poor control (HbA1c >7.5%) were linked to increased cardiovascular risk. Patients with HbA1c below 5.5% exhibited a significantly higher risk of cardiovascular mortality, while HbA1c above 8% was also associated with poor outcomes. Conclusion: Maintaining HbA1c levels in the moderate range (6.5%–7.5%) appears to provide optimal cardiovascular protection for patients with DM post-PCI. Strict or poor glycaemic control increases the risk of adverse outcomes. Keywords HbA1c, cardiovascular outcomes, percutaneous coronary intervention, diabetes mellitus, major adverse cardiovascular events

Item Type:	Article (Review)
Uncontrolled Keywords:	HbA1c, cardiovascular outcomes, percutaneous coronary intervention, diabetes mellitus, major adverse cardiovascular events
Subjects:	R Medicine > RM Therapeutics. Pharmacology > RM283 Endocrinotheraphy R Medicine > RM Therapeutics. Pharmacology > RM300 Drugs and their action
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Pharmacy > Department of Pharmacy Practice Kulliyyah of Pharmacy
Depositing User:	Dr Zohra Bhatti
Date Deposited:	30 Jun 2026 12:09
Last Modified:	30 Jun 2026 12:09
Queue Number:	2026-06-Q3809
URI:	http://irep.iium.edu.my/id/eprint/129553

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