Author + information
- Min Soo Cho1,
- Yu Na Kim1,
- Cheol Hyun Lee1,
- Mineok Chang1,
- Pil Hyung Lee1,
- Jae-Hyung Roh1,
- Sung-Han Yoon1,
- Jung-Min Ahn1,
- Duk-Woo Park2,
- Soo-Jin Kang1,
- Seung-Whan Lee1,
- Young-Hak Kim1,
- Cheol Whan Lee1,
- Seong-Wook Park1 and
- Seung-Jung Park1
The influence of diabetes mellitus (DM) on the clinical outcomes after PCI for the multi-vessel coronary artery disease (CAD) using drug eluting stent (DES) were not well defined to date.
We evaluated the clinical outcomes after PCI using DES for multi-vessel CAD in patients with or without DM. From January 2003 to December 2013, a total of 5057 patients underwent PCI for the multi-vessel CAD with (n=1738) or without (n=3319) DM were included. The primary outcome was the incidence of major adverse cerebrovascular and cardiac events (MACCE) at 5 years, defined as a composite of death, myocardial infarction (MI), ischemic stroke, and repeat revascularization (RR).
After multivariable adjustment, there were trend of increased 5-year risk of MACCE in the DM patients (Hazard ratio [HR] 1.128, 95% confidence interval [CI] 0.989-1.286 p=0.072), mainly driven by increased risk of hard outcomes (HR 1.445, 95% CI 1.164-1.793, p=0.001 for death; HR 1.289, 95% CI 1.067-1.558, p=0.008 for composite of death, MI, and stroke). However, the risk of repeat revascularization was comparable between DM and non-DM patients (HR 1.021, 95% CI 0.861-1.211, p=0.808), despite of unfavorable procedural characteristics, including lesser complete revascularization (36.5% vs. 39.0%, p=0.082) and longer total stent length (62.9±34.4mm vs. 60.0±33.1mm, p=0.001). The risk of target lesion revascularization (HR 1.146, 95% CI 0.913-1.440, p=0.241) was also not significantly different between two groups.
|Outcomes||Hazard ratio||95% confidence interval||P value|
|Death, myocardial infarction, and stroke||1.289||1.067-1.558||0.008|
|Target vessel revascularization||1.143||0.930-1.406||0.204|
|Target lesion revascularization||1.146||0.913-1.440||0.241|
|New lesion revascularization||1.116||0.825-1.509||0.477|
MACCE, major adverse cardio and cerebrovascular event.
Although risk of hard outcomes after PCI were still higher in the DM patients, the risk of revascularization was comparable between DM and non-DM patients in the era of DES.
Diabetes, Multivessel disease, Percutaneous coronary intervention