Prognostic Impact of Diabetes Status on Outcomes After Physiology-Guided Revascularization ― Insights From the J-PRIDE Registry ―
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The prognostic impact of diabetes status on outcomes after physiology-guided revascularization remains unclear. This study evaluated clinical outcomes in patients with insulin-treated diabetes (ITD), non-ITD (NITD), and without diabetes after physiology-guided revascularization. METHODS AND RESULTS: From the J-PRIDE registry, 3,140 patients were categorized into non-diabetes (n=1,797), NITD (n=1,133), and ITD (n=210) groups. The primary endpoint was the 1-year incidence of target vessel failure (TVF), a composite of cardiac death, target vessel-related myocardial infarction, and clinically driven target vessel revascularization. The 1-year TVF rate was significantly higher in the ITD and NITD groups than in the non-diabetes group (6.1% and 4.1% vs. 2.0%, respectively), with adjusted hazard ratios for the ITD and NTD groups of 2.14 (95% confidence interval [CI] 1.09-4.19; P=0.027) and 1.63 (95 CI 1.02-2.61; P=0.041), respectively. The non-hyperemic pressure ratio cut-off predicting fractional flow reserve (FFR) ≤0.80 was lower in the ITD than NITD and non-diabetes groups (0.87 vs. 0.89 and 0.90, respectively). The ITD group had the highest risk of TVF across all FFR values, followed by the NITD and non-diabetes groups. CONCLUSIONS: Patients with ITD and NITD exhibit worse clinical outcomes than those without diabetes. Notably, patients with ITD remained at elevated risk across the entire FFR spectrum, suggesting that physiological severity alone may not fully capture their residual cardiovascular risk.
Source: Circulation Journal
Authors: Masahiro Takeo, Shoichi Kuramitsu, Hiroki Okabe, Yutaro Naka, Tomohiro Shinozaki, Yoshiaki Kawase, Takenori Domei, Futoshi Yamanaka, Umihiko Kaneko, Tsunekazu Kakuta, Kazunori Horie, Hidenobu Terai, Hirohiko Ando, Yasutsugu Shiono, Toru Tagashira, Kazutaka Nogi, Takashi Kubo, Taku Asano, Jun Shiraishi, Hiromasa Otake, Akinori Sugano, Atsushi Iwai, Yuetsu Kikuta, Hidetaka Nishina, Masaharu Kataoka, Masashi Iwabuchi, Hiroyoshi Yokoi, Tetsuya Amano, Takashi Akasaka, Hitoshi Matsuo, Nobuhiro Tanaka, on behalf of the J-PRIDE Investigators
Institutions: University of Occupational and Environmental Health Japan, The University of Tokyo, Gifu Heart Center, Kokura Memorial Hospital, Shonan Kamakura General Hospital, Tsuchiura Kyodo General Hospital, Sendai Kousei Hospital, Kanazawa Hospital, Aichi Medical University, Wakayama Medical University, Wakayama University, Kita Harima Medical Center, Nara Medical University, Tokyo Medical University Hachioji Medical Center, St. Luke's International Hospital, Japanese Red Cross Society Kyoto Daini Hospital, Kobe University, Ibaraki Prefectural Central Hospital, Nara Prefecture Seiwa Medical Center, Fukuyama Cardiovascular Hospital, Tsukuba Medical Center Hospital, University of the Ryukyus, Fukuoka Sanno Hospital, Nishinomiya Watanabe Cardiovascular Center
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7222940496