Background. Whether good glycemic control can result in clinical benefits for diabetic chronic total occlusion (CTO) patients is still a matter of debate. Methods. We studied 1029 diabetic CTO patients. Based on one-year glycosylated hemoglobin A (HbA1c) levels, we assigned the patients into 2 groups: HbA1c<7% group (n = 448) and HbA1c ≥ 7% group (n = 581). We further subdivided the patients into the successful CTO revascularization (CTO-SR) and nonsuccessful CTO revascularization (CTO-NSR) groups. Kaplan–Meier analysis and Cox regression before and after propensity score matching were used to compare major adverse cardiovascular events (MACE) and other endpoints. Results. There were no significant differences between the groups in terms of most endpoints in the overall patients. After propensity score-matched analysis, patients with HbA1c < 7.0 tended to be superior in terms of MACE, which was mainly attributed to repeat revascularization but the other endpoints. Furthermore, the benefit of the HbA1c < 7 group was more prominent among patients with CTO-NSR in terms of MACE, repeat revascularization, and target vessel revascularization (TVR); and the improvement of the HbAc1 < 7 group was more prominent among patients without chronic heart failure (CHF) (). Conclusions. HbA1c < 7.0 was associated with a reduced incidence of MACE, which was mainly attributed to a reduction in repeat revascularization. Good glycemic control can improve diabetic CTO patients’ clinical prognosis, especially in CTO-NSR patients.

中文翻译：

---

糖尿病慢性完全阻塞患者的血糖控制状态和长期临床结果：一项观察性研究

背景。良好的血糖控制是否可以为糖尿病慢性完全阻塞（CTO）患者带来临床益处仍是一个有争议的问题。方法。我们研究了1029名糖尿病CTO患者。根据一年糖基化血红蛋白A（HbA1c）水平，我们将患者分为两组：HbA1c <7％组（n  = 448）和HbA1c≥7％组（n  = 581）。我们进一步将患者分为成功的CTO血管重建术（CTO-SR）和失败的CTO血管重建术（CTO-NSR）组。倾向评分匹配前后的Kaplan–Meier分析和Cox回归用于比较主要不良心血管事件（MACE）和其他终点。结果。在总体患者的大多数终点方面，两组之间无显着差异。经过倾向评分匹配分析后，HbA1c <7.0的患者在MACE方面趋于优越，这主要归因于重复血运重建，但其他终点。此外，在CTO-NSR的患者中，就MACE，重复血运重建和靶血管血运重建（TVR）而言，HbA1c <7组的获益更为明显。在没有慢性心力衰竭（CHF）的患者中，HbAc1 <7组的改善更为显着（）。 结论。HbA1c <7.0与MACE发生率降低有关，这主要归因于重复血运重建的减少。良好的血糖控制可以改善糖尿病CTO患者的临床预后，尤其是在CTO-NSR患者中。