There are few reports showing the relationship between diabetes and the long-term outcome following percutaneous coronary intervention (PCI) in Asians. As well, the association between glycosylated hemoglobin (HbA1c) level and outcome remains controversial. In this analysis, 748 Japanese patients including 298 with diabetes (DM) and 450 without diabetes (non-DM) who underwent PCI from 1984 to 1992 were evaluated over the long term. The mean follow-up was 12.0 +/- 3.6 years. There were 47 (15.8%) total deaths in DM and 41 (9.1%) in non-DM [hazard ratio (HR) 1.71, 95% confidence interval (CI) 1.11-2.65, P = 0.013] and 28 (9.4%) cardiovascular deaths in DM and 19 (4.2%) in non-DM (HR 2.09, 95% CI 1.14-3.81, P = 0.016). Among DM, increased HbA1c was associated with both total (HR 1.25, 95% CI 1.03-1.53, P = 0.024) and cardiovascular (HR 1.30, 95% CI 1.00-1.69, P = 0.048) mortality. Even in Asians, DM showed an increased mortality following PCI. Among DM, increased HbA1c level was also associated with mortality.