Author + information
- Zhen Ge1,
- Jing Kan2,
- Junjie Zhang3,
- Suiji Li4,
- Nailiang Tian5,
- Fei Ye6,
- Xue-Song Qian7,
- Song Yang8,
- Tanveer Rab9 and
- Shao-Liang Chen10
- 1Icahn School of Medicine at Mount Sinai, New York, New York, United States
- 2Nanjing First Hospital, Nanjing, Jiangsu, China
- 3Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
- 4The first hospital of Jintan City, Changzhou, Jiangsu, China
- 5Nanjing First Hospital, nanjin, China
- 6Nanjing First Hospital, Nanjing, China
- 7zhangjiagang people hospital, zhangjiagang, Jiangsu, China
- 8Yixin people hospital, Yixin, Jiangsu, China
- 9Emory University Hospital, Atlanta, Georgia, United States
- 10Nanjing First Hospital of Nanjing Medical Center, Nanjing, Jiangsu, China
Type 2 diabetes correlates with clinical events after the implantation of a second-generation drug-eluting stent (DES). The rate and prognostic value of stent fracture (SF) in patients with diabetes who underwent DES implantation remain unknown.
We prospectively analyzed consecutive patients from a multicenter registry study, who underwent DES implantation between June 2004 and August 2014. The primary endpoints included the incidence of SF and a composite major adverse cardiac event [MACE, including myocardial infarction (MI), cardiac death, and target-vessel revascularization (TVR)] at 1-year follow-up and at the end of follow-up for overall patients, and target lesion failure [TLF, including cardiac death, target vessel myocardial infarction (TVMI) and target lesion revascularization (TLR)] at the end of study for SF patients.
A total of 3411 patients, of those 1160(34%) with diabetes, underwent surveillance angiography at 1 year after second-generation DES implantation. Diabetes was associated with a higher rate of MACE at 1-year (18.4% vs. 12.9%) and end of follow-up (24.0% vs. 18.6%, all p<0.001), compared with those in patients who did not have diabetes. The 1-year SF rate was comparable among patients with diabetes (n=153,13.2%) and non-diabetic patients (n=273, 12.1%, p>0.05). Diabetic patients with SF had a 2.6-fold increase of SF-related cardiac death at the end of study and 3-fold increase of re-repeat TLR when compared with non-diabetic patients with SF (5.9% vs. 2.2%, p=0.040; 6.5% vs. 2.2%, p=0.032), respectively.
Given the fact that diabetes is correlated with increased MACE rate, SF in diabetic patients translates into differences in mortality and re-repeat TLR compared with the non-diabetic group.
CORONARY: Angioplasty Overview and Outcomes