Knowledge and attitude toward eye disorders in children among pediatricians and family physicians: a survey study.

BACKGROUND: Vision-related disorders are common in children. Therefore, eye examination and thorough visual assessment by first-contact physicians are crucial in children. This study aimed to evaluate the knowledge of and attitude toward children's eye disorders among pediatricians and family physicians in the Ministry of National Guard Health Affairs-Western Region (MNGHA-WR) of Saudi Arabia. METHODS: In this observational, cross-sectional study, we used a self-administered, web-based questionnaire. The sample size was calculated to be 148 pediatricians and family physicians (of 240 in total) currently working at MNGHA-WR. The first section of the questionnaire dwelled on demographics, while the second section addressed the physician's knowledge of and attitude toward commonly encountered ophthalmological pathologies in children. Data collected were entered into Microsoft Excel and then transferred to IBM SPSS version 22 for statistical analysis. RESULTS: A total of 148 responses (92 family physicians and 56 pediatricians) were received. Most of the participants were residents or staff physicians (n = 105, 70.9%). The mean knowledge score of the respondents was 54.67% ± 14.5%. Participants' knowledge was further subclassified using Bloom's original cutoff points into high (n = 4, 2.7%), moderate (n = 53, 35.8%), and low (n = 91, 61.5%) levels of knowledge. Regarding practices, 120 (81%) participants performed ophthalmic examinations; however, only 39 (26.4%) conducted routine examinations as part of every child's visit. Fundus examinations were performed by 25 (16.9%) physicians. A significant deficiency in knowledge was noted in those with < 1 year of work experience (P = 0.014). Although statistically not significant (P = 0.052), family physicians possessed better knowledge than pediatricians regarding children's eye disorders. On the contrary, more pediatricians performed eye examinations than family physicians (P = 0.015). The male sex was also associated with higher rates of eye examination (P = 0.033). CONCLUSION: An unsatisfactory level of knowledge of eye disease among participating doctors was reported. The proportion was significantly higher among residents and staff physicians. Therefore, awareness efforts should be incorporated in both family medicine and pediatrics residency programs to limit the number of cases of ocular disorders going undiagnosed in children.

Risk Factors for Postoperative Infections in Cardiac Surgery Patients: A Retrospective Study.

Background and objective Cardiac surgery is one of the most common surgical procedures globally; its incidence has been on the rise due to the faster pace of population aging thanks to technological and epidemiological advances. Patients who undergo cardiac surgeries may face various postoperative complications that might affect their survival, and one of these major complications is infection. Nosocomial pneumonia, surgical site infection (SSI), mediastinitis, bacteremia, and sepsis are common infections encountered after surgeries. In this study, we aimed to determine the common risk factors related to postoperative infections at the King Faisal Cardiac Center from January 2014 to September 2020. Materials and methods  Records from 364 patients who underwent cardiac surgery and were aged above 18 years were assessed for postoperative infections in this retrospective cohort study. Patients who were immunosuppressed or had active systemic infections were excluded. Consent was waived by the Institutional Review Board. All procedures were performed at the King Faisal Cardiac Center, National Guard Hospital, Jeddah. Results Of the total 364 patients, 105 were women and 259 were men. The mean age of the cohort was 59 years (SD = 13) and the mean BMI was 29.1 kg/m2 (SD = 5.3). The study population showed a high prevalence of cardiac risk factors and diseases: diabetes (n = 244, 67%), hypertension (n = 230, 63%), dyslipidemia (n = 144, 40%), smoking (n = 80, 22%), heart failure (n = 41, 11%), and chronic obstructive pulmonary disease (n = 6, 1.6%). The overall rate of postoperative infection was 32.7% (n = 120), and 17 (14%) of these infected patients underwent reoperations for infection. Conclusion Based on a thorough analysis of 364 patients undergoing various cardiac surgical procedures, including a multivariate analysis accounting for preoperative factors, there was a significant association between postoperative infections and hypertension, diabetes, increased preoperative activated partial thromboplastin time, and elevated HbA1c.

Public Use of Complementary Medicine for Children in Saudi Arabia: A Questionnaire-Based Cross-Sectional Study.

BACKGROUND AND OBJECTIVES: The use of complementary and alternative medicine (CAM) is growing among adults and children. Extensive data is available regarding the pattern and frequency of CAM used in adults in Saudi Arabia, but limited data is available for children. This study aims to examine the level of knowledge, attitude, and practice about the use of CAM in the pediatric population in Saudi Arabia. SUBJECTS AND METHODS: A cross-sectional descriptive study on the use of CAM in children was carried out in the general population of Saudi Arabia. Data was collected by non-probability consecutive sampling technique through an online-based questionnaire from 132 participants. In addition, data analysis was done using IBM's Statistical Package for the Social Sciences (SPSS). The data collected consisted of socio-demographic details, knowledge, attitude, and practice of CAM in children. RESULTS: CAM was reported in all 132 participants (100%), with 45% (N=59) using it without informing their physicians. The mean age of the children was 17 months old, 55.3% (N=73) children were males, and 44.7% (N=59) were females. The most common form of CAM used was herbal medicine, 91% (N=120), while alternative medicine was used in 16.7% (N=12) of the children. Honey was the most used herb (68.2%, N=90), followed by anise (65.2%, N=86), Zamzam water (holy water) (59.1%, N=78), and olive oil (56.8%, N=75). CONCLUSIONS: The use of CAM is very common for children in the general population of Saudi Arabia, with herbal medication being the most common. This constitutes a dire need to regulate this field and provide enough information for the public and health care practitioners to provide the best health care. In addition, future awareness campaigns are needed to bridge the communication gap between parents and physicians and provide better information about the benefits and safety of CAM use.

Risk Factors of Persistent Pulmonary Hypertension in Neonate in A Tertiary Care Referral Center.

BACKGROUND: Persistent pulmonary hypertension of the newborn (PPHN) is a condition in which pulmonary vascular resistance fails to decrease after birth. PPHN leads to hypoxemia due to right-to-left shunting of the blood through the fetal circulation. This study aimed to determine the association between PPHN and prematurity in neonates admitted to the neonatal intensive care unit (NICU). MATERIALS AND METHODS: This study is a single-center, retrospective, and cross-sectional study. Patients diagnosed with PPHN had been selected by using a non-probability consecutive sampling technique from 2016 to 2020 at King Abdulaziz Medical City in Jeddah, Saudi Arabia. Patients with PPHN who did not admit to NICU were excluded. RESULTS: Fifty-six patients had met the inclusion and exclusion criteria. Twenty-six neonates were born prematurely before 37 weeks of gestation, and 30 were born at 37 weeks or more. Among the study population, respiratory complications were seen in 30 patients with a rate of 53.6%. The most common complications were respiratory failure, persistent pulmonary hypertension, and cardiopulmonary arrest. CONCLUSION: Mortality was documented in 26 patients, with the complicated group having a rate of 73.3% compared to the uncomplicated group 15.4%. The most common complications seen in our patients were respiratory failure, persistent pulmonary hypertension, and cardiopulmonary arrest.

Risk Factors for Recurrence of Peptic Ulcer Disease: A Retrospective Study in Tertiary Care Referral Center.

Backgrounds Peptic ulcer disease (PUD) is a common gastrointestinal tract disease characterized by mucosal damage secondary to pepsin and gastric acid secretion. This study evaluated the five-year recurrence rate for patients with PUD and risk factors contributing to PUD relapses. Methods From 2016 through 2021, all patients with endoscopy-proved PUD were identified by reviewing medical records (Best-Care system). Possible risk factors including smoking, nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, alcohol, caffeine, and steroids were analyzed by multivariate analysis. Treatment outcomes, 5-year recurrence rate, and mortality rate were assessed. Results Among 223 patients, there were 187 (83.8%) diagnosed with endoscopy-proved PUD and 36 (16.2%) diagnosed with clinical PUD. Among them, 126 (56.5%) patients were males, and the mean age was 62±2 years. The five years recurrence rate of PUD was 30.9%. There was no significant difference in the recurrence rate between the duodenal ulcer (33.3%) and the gastric ulcer (28.8%). By univariate analysis, the use of steroids and NSAID and Helicobacter pylori (H. pylori) infection were potential risk factors for PUD (P < 0.005). The common complication of PUD was gastrointestinal bleeding (34.1%). Patients who had a complicated PUD were associated with a higher rate of recurrence (45.9%) compared to the uncomplicated PUD (19.2%) (P > 0.05). Conclusion Our findings demonstrated that the five years recurrence rate of PUD was 30.9%. The use of steroids and NSAID and H. pylori infection were risk factors for recurrence of PUD. PUD places a significant burden on health care systems. Therefore, a multicenter prospective study is needed for effective management to prevent recurrence and complications of PUD.

The Incidence and Risk Factors of Cisplatin and Carboplatin Ototoxicity in Pediatric Oncology Patients at Tertiary Oncology Center.

Pediatric cancers are relatively rare diseases when considering all types of cancer. Platinum-based chemotherapeutic agents are potent agents against a variety of pediatric malignancies. An important adverse effect of platinum-based agents is the occurrence of hearing loss. This hearing loss can pose a challenge to detect especially if the child is in his early of life. It will also significantly affect the child development of social, pedagogical, and personal dimensions. It is integral to identify incidence of platinum-based ototoxicity and risk factors that increase the likelihood of developing hearing loss in cancer children. We performed a retrospective chart review of 123 pediatric patients who had completed cisplatin and carboplatin therapy for a variety of malignancies. Patients were diagnosed at Princess Nourah Oncology Centre between January 2011 and December 2016, were less than 14 years old at diagnosis. Audiograms were scored using the International Society of Pediatric Oncology (SIOP) Boston Scale (0-4), a validated grading system for cisplatin-related hearing loss. Ototoxicity was reported in 16 patients out of 123 with a rate of 13%. The incidence of ototoxicity was highest in CNS tumors such as medulloblastoma (37.5%) and optic glioma (25%). Males were at greater risk for developing hearing loss than females. Cumulative cisplatin dose and addition radiation therapy were also identified as risk factors for development of ototoxicity (P = 0.008). Nature and location of cancer, gender, cumulative dose, and addition of radiation therapy are important clinical biomarkers of cisplatin ototoxicity.

Large left ventricular thrombus surgically resected in a patient with normal ejection: A case report.

INTRODUCTION: A left ventricular thrombus is very rare in a patient with normal systolic function. We are reporting a case of left ventricular thrombus in a patient with an abnormal presentation and normal ejection fraction. PRESENTATION OF CASE: A 57-year-old female patient presented with severe epigastric and central abdominal pain associated with nausea, vomiting, constipation, and a decrease in appetite. Post-contrast abdominal computerized tomography (CT) scan revealed multiple splenic infarcts. On echocardiographic study, a huge hyperechogenic, mobile mass was seen attached to the septo-apical wall of the left ventricle measuring 20 mm × 40 mm. Magnetic resonance imaging (MRI) also showed transmural late gadolinium enhancement in the apex which is suggestive of small myocardial infarction in the distal left anterior descending territory. Coronary angiogram showed non-occluded coronaries. The patient was treated surgically due to the urgency of the situation and the high risk of embolization. DISCUSSION: Our patient was on both progesterone and high dose tofacitinib. It is hypothesised that patient most likely experienced asymptomatic myocardial injury with non-occluded coronaries (MINOCA) weeks prior to the presentation. Involvement of distal left anterior descending artery caused apical akinesia resulting in blood stasis. Accompanying subendocardial injury and hypercoagulable state, due to being on progesterone and tofacitinib, led to the formation of the left ventricular thrombus. CONCLUSION: Due to the serious outcomes associated with an untreated left ventricular thrombus, it is necessary to carefully assess all patients suffering from systemic embolism with echocardiogram. Assessing the left ventricular mass with MRI was crucial to understanding the nature of the mass. Size, mobility, and protruding nature where characteristics that warranted urgent surgical intervention due to the high risk of embolization. Finally, it is important to note that tofacitinib might be a new suspect for left ventricular clots.

Ophthalmic Manifestations in Acute Leukemia Patients and Their Relation With Hematological Parameters in a Tertiary Care Center.

BACKGROUND:  Leukemia is a neoplastic disorder that affects blood and bone marrow and is characterized by white blood cells' abnormal proliferation. Leukemia patients may present with different ophthalmic manifestations. This study aims to provide an updated data about the prevalence and types of ocular manifestations in acute leukemia patients and their relation with the hematological parameters. METHODS:  This retrospective cross-sectional study included all acute leukemia patients diagnosed from 2015 to 2020 and underwent an ophthalmic examination during this period at King Abdulaziz Medical City in Jeddah. RESULTS: Eighty-one patients met the inclusion and exclusion criteria and had ophthalmic examinations. Forty-three (53.1%) patients were males, and 38 (46.9%) patients were females. Acute lymphocytic leukemia (ALL) was diagnosed in 55 (67.9%) patients, while acute myelogenous leukemia (AML) was diagnosed only in 26 (32.1%). Ophthalmic manifestations were observed in 23 patients with a prevalence of 28.4%. AML patients had more manifestations with a rate of 38.5%. ALL had a rate of 23.6% (p=0.1). Retinal hemorrhage was the most commonly seen manifestation in six patients. CONCLUSION:  Ophthalmic manifestations are not uncommon in acute leukemia patients. Low hemoglobin and RBC could give an idea about the type of ophthalmic manifestation, not the presence or absence. It is highly recommended to examine acute leukemia patients routinely prior, during, and after the treatment to prevent serious ocular damage and monitor the course of the disease.

Diagnostic Value of Single-Photon Emission Tomography Stress Test in Patients With Suspected Coronary Artery Disease in Saudi Arabia.

Background Invasive coronary angiography (ICA) is the gold standard procedure for the diagnosis of coronary artery disease (CAD). ICA allows for clear visualization of the coronary arterial blood flow. Single-photon emission computed tomography (SPECT) is currently in widespread use to non-invasively evaluate patients known or suspected of coronary artery disease (CAD). This study aimed to examine the association between (SPECT) stress test and elective ICA in terms of diagnostic value in patients suspected of coronary artery disease at the King Faisal Cardiac Center (KFCC), Jeddah, Saudi Arabia. Methods This study is a retrospective diagnostic validation study using a consecutive sampling technique to select the study sample at KFCC. The study included all patients who presented with chest pain that were investigated with either exercise or pharmacologic myocardial perfusion SPECT study followed by elective ICA within six months from January 2015 to January 2020. Results A total of 207 patients met the inclusion criteria, where 43% (n = 90) of patients were females and 57% (n = 117) were males; 68% (n = 141) of the patients had both test results concordant (both SPECT and ICA results were in agreement). In 32% of the patients (n = 66), there was a discordant result (discrepant result between SPECT and ICA). SPECT had a sensitivity of 92.4% and a specificity of 26.3%. SPECT had a negative predictive value of 0.68 and a positive predictive value of 0.66 compared to ICA. There was a low degree of reliability between SPECT and ICA. Conclusion Reliability between the SPECT and ICA in exclusion of significant CAD is high. The rate of false-positive tests was high while the accuracy of SPECT in detecting CAD in patients with diabetes and hypertension was high. The overall reliability of SPECT to ICA in the Saudi population was low.

COVID-19-Related Pulmonary Embolism: Incidence, Characteristics, and Risk Factors.

INTRODUCTION:  The 2020 world pandemic caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was initially reported in December 2019 in Wuhan, China, which has since then spread globally. Several studies on patients with coronavirus disease 2019 (COVID-19) describe a high risk of pulmonary embolism (PE). The majority of PEs in patients with COVID-19 were in the segmental arteries. Therefore, this study aims to determine the rate of PE in patients with COVID-19 at King Abdulaziz Medical City in Jeddah, Saudi Arabia. Other risk factors of PE were taken into consideration. PATIENTS AND METHODS:  This study is a single-center, retrospective, cross-sectional study that used a non-probability consecutive sampling technique to select the patients. The local institutional review boards approved the study protocol. Overall, 91 consecutive patients who were older than 18 years of age and who had a computerized tomography (CT) pulmonary angiography were included in this study. RESULTS:  Ninety-one patients met the inclusion and exclusion criteria, of whom 46 (50.5%) were females and 45 (49.5%) were males. The study population's age ranged from 19 to 87 with a mean age of 59 ± 15 years. PE was documented in 11 patients (12.1%). Seventy-three patients underwent CT scan angiography during COVID-19 manifestation, while 18 patients had it after recovering from COVID-19. Out of the 11 patients with PE, eight were diagnosed with PE while being COVID-19 positive, and three were diagnosed with PE after recovery from COVID-19. CONCLUSION: Several potential clinical implications can be concluded for this study. Firstly, effective evaluation of the risk of PE in patients with COVID-19 is based on clinical findings such as chest pain, hemoptysis, lower limb edema, and, most significantly, shortness of breath. Secondly, measuring D-dimer remains an effective test for ruling out PE in patients with COVID-19 as in patients without COVID-19.

Common Types of Falls in the Elderly Population, Their Associated Risk Factors and Prevention in a Tertiary Care Center.

Introduction Falls in elderlies are one of the leading causes of emergency visits worldwide. It is also a major cause of morbidity and mortality and imposes a significant burden on health care costs. This study investigates risk factors in elderlies aged 65 and above that contribute to falls. Methodology This study is a cross-sectional study using a non-probability consecutive sampling technique. The records of 300 clinical data of elderly who underwent falls were collected from all confirmed cases of falls from January 2015 to January 2020, at National Guard Hospital in Jeddah, Kingdom of Saudi Arabia. Results Patients included in this study were ranged in age from 65 to 85 years with a mean age of 77.6 years (SD = 8.1 years). Among our population, 149 (53.4%) were males, and 130 (46.6%) were females. Some comorbidities were associated with our population such as diabetes mellitus (69.2%, n = 193), hypertension (75.3%, n = 210), smoking (6.1%, n = 6.1), and polypharmacy (18.3%, n = 51). Conclusion Understanding and evaluating risk factors can help to decrease or even prevent falls. Smoking and dementia are strongly related to increased mortality rate. Some outcomes of falls such as head injuries and ICU admission had a strong association to increased mortality. Physical therapy or occupational therapy found to be a strong factor to decrease fall recurrence.

Association Between Post-Operative Infection and Blood Transfusion in Cardiac Surgery.

Background Blood transfusion is a commonly used therapy in cardiac surgery, whether it is given during the surgery or in the intensive care unit. It is important to evaluate the risks and benefits of exposure to blood transfusion. The use of blood transfusions can influence patient outcome. Previous studies have implicated blood transfusion as a causative factor in post-operative infection. Objectives We aim to determine the effect of blood transfusion on post-operative infection in cardiac surgery patients at the King Faisal Cardiac Center, Jeddah, Saudia Arabia, from January 2017 to January 2019. Methods The regular six-week follow-up of cardiac surgery patients allowed us to maintain a six-week infection span. The main variables included patient characteristics, operative characteristics, pre-operative hemoglobin, six-week infection, blood transfusion, and clinical outcomes. A logistic regression model was developed to identify patient and procedure variables that were associated with blood transfusion and infection. The baseline variables were entered into the model. Variables with p-value less than 0.05 were considered significant. Results The incidence of transfusion out of 197 patients was 93.4% (n = 184). The occurrence of infection was 31.82% (n = 63). There was no difference in post-operative infection for patients who received blood transfusions compared with those who did not receive blood transfusions (p = 0.902). In comparing patients receiving 1-2 units of red blood cells (RBCs) (48%) and those receiving >2 units of RBCs (52%), there was no significance (p = 0.549). Conclusions There was no association between the incidence of infection and blood transfusion. While there are other reasons for withholding blood, it would not be recommended to do so based on the concern of infection.

Frequency and Characteristics of Incidental Pulmonary Embolism in Cancer Patients: A Retrospective Study at a Large Oncology Center in Saudi Arabia.

INTRODUCTION: Oncology patients are predisposed to incidental-asymptomatic Pulmonary Embolism (PE) which has a substantial morbidity and mortality in untreated patients. As the cancer patients frequently undergo contrast enhanced Computed Tomography (CT) scanning for staging their primary disease, there is a higher chance of detecting unsuspected PE. METHODOLOGY: Our sample included a retrospective review of one-thousand consecutive oncology patients who had CT scan of the chest for reasons other than PE. We excluded females on oral contraceptives, patients who had a prior history of PE or deep veins thrombosis, and history of intensive care unit admission, surgery, trauma, or lower limb fractures within 6 months prior to the CT study. A positive case of incidental PE is considered if it was confirmed by CT pulmonary angiogram study within 24 hours of the staging CT or if there is an agreement for positive PE by two experienced radiologists. The overall incidence of asymptomatic PE in cancer patients, rate of incidental PE in different types and stages of cancer, and location of the PE within the pulmonary vasculature are described. DISCUSSION: The true incidence, prevalence, and mortality rates of incidental PEs in oncology patients is underestimated due to its silent nature. Since the mortality and morbidity are exceptionally high in cancer patients with incidental pulmonary embolism, staging CT chest examinations should include a meticulous search for incidental PE. CONCLUSION: The rate of pulmonary embolism in oncology patients is higher in female and in the advanced stage of the disease. There are certain tumors associated with a higher rate of incidental PEs, which may be related to tumors characteristics or to its treatment.

Rapid Shallow Breathing Index as a Predictor of Extubation Outcomes in Pediatric Patients Underwent Cardiac Surgeries at King Faisal Cardiac Center.

Introduction Weaning patients of ventilation is an important step in the intensive care unit; therefore, assessing the perfect timing to do such critical action is of equal significance to prevent complications. Rapid shallow breathing index (RSBI) has been used as a prediction tool for weaning adult patients, but for pediatric patients it is still an area of unclarity. Accordingly, the aim of this study is to evaluate the RSBI as a predictor of extubation outcome in pediatric patients underwent cardiac surgery at King Faisal Cardiac Center from 2016 until 2019. Methods A retrospective cohort study was conducted at King Faisal Cardiac Center on all extubated children having cardiac surgeries from 2016 to 2019 with excluding the patients who were admitted for causes other than cardiac surgery. Their age was ranged from birth until 14 years. Moreover, the patients were grouped based on the extubation outcomes into: success, success with non-invasive ventilation, or failure which was defined as reintubation within 48 hours after extubation. Regarding the collected data, three readings of RSBI on hourly basis prior to extubation were calculated by dividing respiratory rate (RR) over tidal volume (VT) with a correction based on the body weight. Results A total of 86 patients met the inclusion and exclusion criteria. Thirty (34.9%) patients were successfully extubated, 51 (59.3%) patients had successful extubation with the use of non-invasive ventilation, and only five (5.8%) patients suffered from extubation failure. Two-hour RSBI as a predictor of outcome had a P-value of 0.003, one-hour RSBI had a P-value of 0.01, RSBI at time of extubation had a P-value of 0.02. Mean corpuscular volume (MCV) is higher in extubation failure group with a p-value of 0.01. Conclusion This study suggests that pediatric patients who suffer from extubation failure usually have a higher RSBI measurement compared to the patients who have a successful extubation. The most significant RSBI measurements to predict the extubation outcome were recorded two hours prior to extubation. Our study also found that extubation failure patients could have higher MCV than the success group.

Glycated Haemoglobin and Outcomes of Percutaneous Coronary Intervention Among Type Two Diabetic Patients in Saudi Arabia.

BACKGROUND: Glycated haemoglobin (HbA1c) is a marker that reflects the control of diabetes mellitus (DM) over a three-month period. We sought to compare cardiovascular outcomes of diabetic patients with and without controlled levels of HbA1c post percutaneous coronary intervention (PCI) presenting to King Faisal Cardiac Center.   Methods: A retrospective single-center study of all patients with type two DM who were treated with PCI during the period between January 2015 and January 2018. All data were obtained from health informatics system. Demographics, clinical data, and major adverse cardiovascular and cerebrovascular events (MACCE) were collected to compare outcomes among diabetic patients with and without controlled HbA1c. RESULTS: The study included 177 patients with type two DM who underwent PCI. The mean age was 63.3 (SD±12). Males represented 73.4% and 26.6% were females. The mean HbA1c on admission was 8.7%. At presentation 31% of the patients had relatively controlled blood sugar (HbA1c mean 7.5%, SD±0.5) and 69% presented with poorly controlled type two DM (mean HbA1c 9.1%, SD±0.25). The prevalence of hypertension and dyslipidaemia were higher among the uncontrolled group, but there were no differences between both groups in the control of blood pressure or dyslipidaemia. Patients in the uncontrolled group had higher rate of prior PCI (36.6%) compared to the controlled arm (16%, p=0.0195) The prevalence of cerebrovascular, cardiovascular, and renal impairment was similar. The use of insulin was higher among the uncontrolled arm. Patients in the controlled arm had lower incidence of composite endpoints of death and non-fatal myocardial infarction and stroke (MACCE) (14% vs 41%, p=0.001) compared to the uncontrolled arm. CONCLUSION: Among patients with type two DM that were treated with PCI, achieving targets of blood sugar control reflected by glycated haemoglobin is associated with improved survival and lower incidence of composite MACCE.