The Impact of Diabetes Mellitus on Early and Late Mortality and Major Adverse Cardiac Events after Percutaneous Coronary Intervention with Drug-Eluting Stents

2007 ◽  
Vol 16 ◽  
pp. S137 ◽  
Author(s):  
M.J. Butler ◽  
C. Farrington ◽  
J.A. Shaw ◽  
D.J. Clark ◽  
A.E. Ajani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Cardiac Events ◽  
Late Mortality ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
The Impact

The Impact of Diabetes Mellitus on Clinical Outcomes after Percutaneous Coronary Intervention with Drug-Eluting Stents for Left Main Distal Bifurcation Lesions in Patients with Chronic Kidney Disease

2020 ◽  
Vol 10 (6) ◽  
pp. 382-391
Author(s):  
Yusuke Watanabe ◽  
Satoru Mitomo ◽  
Toru Naganuma ◽  
Kensuke Takagi ◽  
Satoshi Matsuoka ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Outcomes ◽  
Coronary Intervention ◽  
Target Lesion ◽  
Drug Eluting Stents ◽  
Left Main ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
Bifurcation Lesions ◽  
The Impact

<b><i>Background:</i></b> The impact of diabetes mellitus (DM) on clinical outcomes after percutaneous coronary intervention (PCI) for unprotected left main (ULM) distal bifurcation lesions in patients with chronic kidney disease (CKD) is poorly understood in the era of drug-eluting stents (DESs). <b><i>Objective:</i></b> We assessed the impact of DM on clinical outcomes after PCI for ULM distal bifurcation lesions in CKD patients compared to patients without DM. <b><i>Methods:</i></b> We identified 1,832 consecutive patients who underwent PCI for ULM lesions at New Tokyo Hospital, Matsudo, Japan, San Raffaele Scientific Institute, Milan, Italy, and EMO-GVM, Centro Cuore Columbus, Milan, Italy between January 2005 and August 2015. Of the 1,832 patients, 1,391 were treated with DESs. We excluded 750 patients without CKD and 89 hemodialysis patients. Finally, 552 patients with CKD were included: 219 with DM (DM group) and 333 without DM (no DM group). The primary endpoint was target lesion failure (TLF) at 5 years. TLF was defined as a composite of cardiac death, target lesion revascularization (TLR), and myocardial infarction. <b><i>Results:</i></b> Patients in the DM group were more likely to have hypertension, dyslipidemia, peripheral artery disease, and lower ejection fraction and were more frequently using insulin for DM. The TLF rate during the follow-up period was significantly higher in the DM than in the no DM group (adjusted hazard ratio [HR] 1.50; 95% confidence interval [CI] 1.06–2.13; <i>p</i> = 0.023). Cardiac mortality was comparable between both groups (adjusted HR 1.11; 95% CI 0.63–1.95; <i>p</i> = 0.71). The TLR rate was significantly higher in the DM group than in the no DM group (adjusted HR 1.69; 95% CI 1.12–2.54; <i>p</i> = 0.012). <b><i>Conclusion:</i></b> DM is strongly associated with adverse event after PCI for ULM distal bifurcation lesions in CKD patients compared to those without DM.

Abstract 13853: Routine Follow Up Coronary Angiography versus Clinical Follow Up Only in Patients With Dyslipidemia Following Percutaneous Coronary Intervention With Drug-eluting Stents: 3-year Clinical Follow Up Results

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Seung Woon Rha ◽  
Byoung Geol Choi ◽  
Se Yeon Choi ◽  
Jae Kyeong Byun ◽  
Jin Oh Na ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Control Group ◽  
Cardiac Events ◽  
Repeat Revascularization ◽  
Percutaneous Coronary ◽  
Drug Eluting

Background: It is unclear whether the routine follow up (FU) coronary angiography (CAG) regardless of patient’s symptoms after successful percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) in patients (pts) with dyslipidemia is beneficial or not. Methods: The study population consisted of 554 consecutive dyslipidemia pts underwent PCI with unrestricted utilization of DESs from January 2004 to May 2011. Routine FU CAG was performed between 6 to 9 months following index PCI and was decided by individual physician’s discretion. Rests of the pts were clinically followed and ischemic driven events were captured. Clinical events including mortality, myocardial infarction and clinically driven PCI before 9 months were excluded in both groups. Cumulative clinical outcomes up to 3 years were compared between the Routine CAG group (n=329 pts) and the Clinical FU group (n= 225 pts). To adjust potential confounders, a propensity score matched (PSM) analysis was performed using the logistic regression model. Results: After PSM analysis, 2 propensity-matched groups (165 pairs, n = 330 pts, C-statistic=0.718) were generated and, the baseline characteristics of the two groups were balanced. At 3 years, the incidence of repeat revascularization and major adverse cardiac events (MACEs) was higher in the Routine CAG group than the control group (Table). Conclusions: Despite the expected beneficial effects, routine FU CAG following index PCI with DESs in dyslipidemia pts was associated with higher incidence of repeat PCI and MACE up to 3 years.

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