Author + information
- Huan-Huan Wang1,
- Zhan Gao2,
- Ying Song1,
- Jing-jing Xu1,
- Ping Jiang1,
- Lin Jiang1,
- Jue Chen3,
- Lijian Gao4,
- Lei Song5,
- Yuejin Yang4,
- Run-Lin Gao6,
- Bo Xu4 and
- Jin-qing Yuan7
- 1Fuwai Hospital, CAMS&PUMC, Beijing, Beijing, China
- 2China Medical Association, Bejing, Hebei, China
- 3Fuwai Hospital, Beijing, Beijing, China
- 4Fu Wai Hospital, National Center for Cardiovascular Diseases, Beijing, China, Beijing, Beijing, China
- 5Fuwai Hospital, Beijing, China
- 6Fu Wai Hospital, Beijing, Beijing, China
- 7Fuwai hospital, CAMS&PUMC, Beijing, Beijing, China
Whether diabetes mellitus (DM) remains an independent predictor of adverse outcomes after modern PCI is under debate. Therefore, we carried out this large sample study in a large Chinese cardiovascular center to investigate the impact of diabetic status on 2-year clinical outcomes in Chinese patients undergoing contemporary PCI treatment.
10,724 consecutive patients (DM = 3238, Non-DM = 7486) underwent PCI at Fu Wai Hospital, National Center for Cardiovascular Diseases, Beijing, China, from January to December in 2013, were prospectively collected. 2-year clinical outcomes were compared between patients with and without DM.
10,669 patients (99.5%) completed 2-year clinical follow-up. Diabetic patients had more baseline clinical risks and more extensive coronary disease. During 2-year follow-up, the rates of all-cause death (DM: 1.5% vs. Non-DM: 1.1%, p=0.045), myocardial infarction (MI) (DM: 2.4% vs. Non-DM: 1.8%, p=0.044), revascularization (DM: 9.5% vs. Non-DM: 8.2%, p=0.031), and major adverse cardiac events (MACE) (all-cause death, MI and TVR ) (DM: 8.8% vs. Non-DM: 6.9%, p=0.001) were significantly higher in DM group. After multivariable-adjusted Cox regression analysis, it was found that only DM, but not the individual components of MACE and stent thrombosis (ST) (all p >0.05) was an independent risk factor of MACE (HR 1.276, 95% CI 1.015-1.362, p = 0.031). After performing propensity score matching (1714 matched pairs), rates of all-cause death, MI, revascularization, stroke, ST, and MACE were not significantly different between two groups (all p >0.05), and DM was not predictive of MACE and any clinical adverse outcomes.
In this large cohort of Chinese patients who underwent modern PCI, diabetic patients had worse prognosis including death and repeat revascularization during 2-year follow-up, but DM was not an independent risk factor of adverse clinical outcomes.