Background:
Diabetic patients are traditionally related to higher rates of major adverse cardiac events (MACE) after percutaneous coronary intervention even in the drug-eluting stent (DES) era. We sought to evaluate the impact of diabetes status in the very long-term clinical outcomes after DES implantation in a complex, non-selected diabetic cohort.
Methods and Results:
Between May/2002 and May/2007, 2,500 patients treated exclusively with DES were consecutively enrolled in the non-randomized, single-center DESIRE Registry. Among them, 1,705 elective patients have completed 6 month-follow-up and were divided into 3 groups according to their
Diabetes mellitus
status. Primary endpoint was long-term combined MACE and stent thrombosis rate classified according to ARC definitions. Clinical follow-up was obtained at 1, 6 and 12 months and then annually up to 6 years. Mean follow-up time was 2.6±1.2 years and was achieved in 98% of the eligible cohort. Baseline clinical and procedure characteristics as well as late outcomes are displayed in the table
. In the multivariate logistic regression analysis, Diabetes mellitus (OR=1.45; 95%Confidence interval-CI 1.00 –2.11) and moderate/severe calcification at lesion site (OR=3.06;95%CI,1.47– 6.34) were independent predictors of MACE .
Conclusions:
In the DESIRE registry both insulin and non-insulin requiring diabetics carried poorer long-term outcomes (MACE) when compared to non-diabetic patients. Importantly, there was a tendency for higher stent thrombosis among diabetics. However, the type of diabetes (insulin vs. non-insulin) did not seem to impact the prognosis of PCI with DES.
THE IMPACT OF MID-TERM OCT FINDINGS ON LONG-TERM CLINICAL EVENTS AFTER DRUG-ELUTING STENTS IMPLANTATION
