Prognostic Impact of Diabetes Status on Outcomes After Physiology-Guided Revascularization ― Insights From the J-PRIDE Registry ―
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.
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BibTeX
@article{takeo2026prognostic,
title = {{Prognostic Impact of Diabetes Status on Outcomes After Physiology-Guided Revascularization ― Insights From the J-PRIDE Registry ―}},
author = {Masahiro Takeo and Shoichi Kuramitsu and Hiroki Okabe and Yutaro Naka and Tomohiro Shinozaki and Yoshiaki Kawase and Takenori Domei and Futoshi Yamanaka and Umihiko Kaneko and Tsunekazu Kakuta and Kazunori Horie and Hidenobu Terai and Hirohiko Ando and Yasutsugu Shiono and Toru Tagashira and Kazutaka Nogi and Takashi Kubo and Taku Asano and Jun Shiraishi and Hiromasa Otake and Akinori Sugano and Atsushi Iwai and Yuetsu Kikuta and Hidetaka Nishina and Masaharu Kataoka and Masashi Iwabuchi and Hiroyoshi Yokoi and Tetsuya Amano and Takashi Akasaka and Hitoshi Matsuo and Nobuhiro Tanaka and on behalf of the J-PRIDE Investigators},
journal = {Circulation Journal},
year = {2026},
month = oct,
doi = {10.1253/circj.cj-26-0508},
url = {https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-26-0508/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Prognostic Impact of Diabetes Status on Outcomes After Physiology-Guided Revascularization ― Insights From the J-PRIDE Registry ―
AU - Masahiro Takeo
AU - Shoichi Kuramitsu
AU - Hiroki Okabe
AU - Yutaro Naka
AU - Tomohiro Shinozaki
AU - Yoshiaki Kawase
AU - Takenori Domei
AU - Futoshi Yamanaka
AU - Umihiko Kaneko
AU - Tsunekazu Kakuta
AU - Kazunori Horie
AU - Hidenobu Terai
AU - Hirohiko Ando
AU - Yasutsugu Shiono
AU - Toru Tagashira
AU - Kazutaka Nogi
AU - Takashi Kubo
AU - Taku Asano
AU - Jun Shiraishi
AU - Hiromasa Otake
AU - Akinori Sugano
AU - Atsushi Iwai
AU - Yuetsu Kikuta
AU - Hidetaka Nishina
AU - Masaharu Kataoka
AU - Masashi Iwabuchi
AU - Hiroyoshi Yokoi
AU - Tetsuya Amano
AU - Takashi Akasaka
AU - Hitoshi Matsuo
AU - Nobuhiro Tanaka
AU - on behalf of the J-PRIDE Investigators
PY - 2026
DA - 2026/10/20
JO - Circulation Journal
DO - 10.1253/circj.cj-26-0508
UR - https://www.jstage.jst.go.jp/article/circj/advpub/0/advpub_CJ-26-0508/_article
AB - 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.
SN - 1347-4820
SN - 1346-9843
ER -