scholarly journals Outcomes of Coronary Angioplasty in Diabetic Patients – A Retrospective Study

2016 ◽  
Vol 01 (02) ◽  
pp. 005-010
Author(s):  
Galla Kishore ◽  
Chandragiri Susmitha ◽  
P Rao
Keyword(s):  
Statistical Significance ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Coronary Syndrome ◽  
Major Cardiovascular Events ◽  
Number Of Patients ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
One Year

AbstractAims: We want to study the effect of diabetes Mellitus (DM) on the outcomes in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) comparing those with non diabetics, with reference to gender.Methods: We retrospectively evaluated the consecutive patients undergoing PCI either with acute coronary syndrome (ACS) or chronic stable angina (CSA) in our institute between March 2014 to March 2015. We followed them up to one year for the major cardiovascular events (MACES) and other complications. We compared the rate of events between diabetic and non diabetic patients along with gender subgroups and tested for the significance.Results: In 645 patients undergone PCI in our institute, 326(50.5%) were diabetics, of them 104(31.9%) were females. Patients with diabetes with CAD were older with more incidence of hypertension and kidney derangement than non diabetics. History of CAD and previous procedure are definitely more in diabetics as is multi vessel disease (p=0.02) and LV dysfunction (p=0.003). Total number of patients presenting with complications within one year of PCI is 18(0.02%). Of them 14 are males and 4 are females, 14 were diabetics and 4 were non diabetics. There was no statistical significance in the outcomes between female & males (p=0.7), diabetics females & diabetic males (p=0.48) and non diabetics females & nondiabetic males(p=0.7). Male patients with diabetes had significantly more complications than non diabetic males (p=0.05) but there is no significant difference between diabetic and non diabetic females (p=0.59).Conclusion: Patients with DM undergoing PCI had more complications than non diabetics with significant difference between male diabetics and non diabetic males. This difference is not significant between diabetic and non diabetic females.

scholarly journals The Prevalence of Giardia Intestinalis in Dyspeptic and Diabetic Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Gözde Derviş Hakim ◽  
Şafak Kızıltaş ◽  
Hilmi Çiftçi ◽  
Şafak Göktaş ◽  
İlyas Tuncer
Keyword(s):  
Diabetes Mellitus ◽  
Giardia Intestinalis ◽  
Diabetic Patients ◽  
Elisa Method ◽  
Number Of Patients ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
Stool Specimens ◽  
Positive Results ◽  
Healthy Persons

Background and Aims. We aimed to investigate the prevalence of Giardiasis in patients with dyspepsia and patients with diabetes mellitus. Methods. 400 patients and 100 healthy persons were included in this clinical prospective study. The number of patients in each group was equal, 200 dyspeptic and 200 diabetic, respectively. The antigen of G. lntestinalis was determined in the stool specimens by ELISA method. Results. The frequency of Giardiasis was 7% in dyspeptic and 15% in diabetic patients. There was no positive results in any of the healthy persons. There was a significant difference in prevalence rate of Giardiasis between patients with dyspepsia and diabetes mellitus (P<0.05). Conclusions. These results revealed that the prevalence of Giardiasis in dyspepsia and with diabetes mellitus was high in our country. This is the first study investigating the prevalence of Giardiasis in diabetic patients. To investigate Giardiasis in diabetic patients, who have dyspepsia or not, may be a good approach for public health.

scholarly journals Relationship of PRECISE-DAPT and DAPT scores with mortality in patients admitted with acute coronary syndrome who undergo coronary stent implantation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
C Alak ◽  
E Ozpelit ◽  
D Cirgamis ◽  
M Abusharekh ◽  
N Baris
Keyword(s):  
Acute Coronary Syndrome ◽  
Major Bleeding ◽  
Coronary Intervention ◽  
Bleeding Events ◽  
Coronary Syndrome ◽  
Coronary Stent Implantation ◽  
Number Of Patients ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
Relationship Of

Abstract Introduction International guidelines recommend using risk score tools that allow us to assess the risk of bleeding and ischemia when deciding on DAPT. In our research, we aimed to examine the mortality relationship of new risk scores, DAPT and PRECISE-DAPT scores. Method Between 2013–2014, 948 patients admitted to our clinic with ACS were included in our study. We excluded 688 patient (no contact number,CABG, medical treatment, use of oral anticoagulation, active malignant cancer). 260 patients admitted with acute coronary syndrome (58%, 8 STEMI, 35%, 4 non-STEMI, 5%, 4 Unstable angina pectoris) who undergo coronary stent implantation were included in the study. We aimed to focus on the patients who undergo percutaneous coronary intervention and their risk of mortality. The patients' records were retrospectively analyzed through the hospital information system and archive records. Laboratory results, echocardiography and CAG reports of the patients, disease histories were obtained from the information recorded through the system. With these data, PRECISE-DAPT and DAPT scores of patients were calculated. Results The number of patients with a PRECISE-DAPT Score ≥25 was 62 (23.8%). The number of patients with DAPT Score ≥2 was 193 (74.2%). Mortality occurred in 49 (18.8%) patients. Patients with PRECISE-DAPT ≥25 and those with PRECISE-DAPT &lt;25 were compared in terms of mortality and mortality was significantly higher in the high-scoring group [P &lt;0.001 OR 6.94 C (3.53–13.62)]. The patients were divided into 4 groups (PRECISE-DAPT 25 and DAPT ≥2, PRECISE-DAPT ≥25 and DAPT ≥2, PRECISE-DAPT 25 and DAPT 2, PRECISE-DAPT ≥25 and DAPT 2) according to PRECISE-DAPT and DAPT score. Mortality was significantly higher regardless of DAPT score in patients with high PRECISE-DAPT scores (p&lt;0.001). We evaluated the relationship between PRECISE-DAPT score and major bleeding and all bleeding. Compared to the group there was no significant difference in all bleeding events (P=0.56) and major bleeding events (P=0.23). The relationship between bleeding events and mortality was evaluated. There was no significant difference in mortality (p=0.689) with all bleeding events; but mortality was significantly increased in patients with major bleeding [P=0.025 OR 6.16 (1,33–28,49)]. Conclusion In our study, we observed that the patient group with a high PRECISE-DAPT score had a high mortality rate regardless of the DAPT score. The PRECISE-DAPT score is a useful tool in determining the group with high long-term mortality in patients who present with acute coronary syndrome and undergo percutaneous coronary intervention. The clinician should use the PRECISE-DAPT score when deciding on the duration of dual antiplatelet therapy in this patient group and these patients with high scores need to be monitored more closely. The data we have obtained from our study is retrospective and these results need to be supported by prospective and large studies. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Predictive Value of N-Terminal Prohormone of Brain Natriuretic Peptide in Long-Term Remodeling of the Left Ventricle in Diabetic Patients of Young and Middle Age With Acute Coronary Syndrome After Percutaneous Coronary Intervention

2021 ◽  
Vol 9 (4) ◽  
pp. 511-520
Author(s):  
Z. Wang ◽  
E. A. Asaphyeva ◽  
T. I. Makeeva
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Middle Age ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Patients With Diabetes ◽  
Long Term Prognosis

Abstract. Recently, quantitative analysis of the level of the N-terminal prohormone of the brain naturetic peptide (NT-proBNP) has been widely used to diagnose heart failure (HF). A statistically significant correlation was found between the serum NT-proBNP concentration and HF stage. It was found that in patients with high cardiovascular risk, NT-proBNP has the highest predictive value in relation to mortality. In young and middle-aged patients with diabetes mellitus (DM) with myocardial infarction (MI) and stents of an infarct-associated artery, the frequency of unfavorable remodeling (UR) of the left ventricle (LV) in the long-term prognosis was studied. The frequency of atherosclerotic lesions of the coronary arteries (CA) in patients with diabetes in acute coronary syndrome (ACS) was determined, the results of echocardiographic parameters were presented in the follow-up dynamics, the value of serum NT-proBNP in predicting LV UR 12 months after myocardial infarction (MI) was determined.Aim of study. To assess the diagnostic capabilities of NT-proBNP in the long-term prediction of the development of LV infarction in patients with MI with diabetes in young and middle age after percutaneous coronary intervention (PCI).Design. Prospective controlled non-randomized trial. The patients were examined twice: on the first day of ACS after PCI with stenting of infarct-associated coronary artery and 12 months after AMI. The study included 191 patients with ACS with / without ST-segment elevation, who were divided into two groups. The main group included 76 patients with ACS with diabetes mellitus, the comparison group included 115 patients with ACS without diabetes mellitus. Patients in both groups were comparable in age, gender, comorbidity, and complications of AMI. The duration of diabetes was, on average, 6 years (from one to 12 years).Material and methods. All patients underwent electrocardiography, echocardiography, tests for the content of troponin I, NT-proBNP, glycosylated hemoglobin, lipids, determined the level of creatinine in the blood and the glomerular filtration rate according to the Modification of diet in renal disease (MDRD). All patients were examined twice: on the first day of ACS after PCI with stenting of infarct-associated coronary artery and 12 months later.Results. In 69% of diabetic patients with anterior myocardial infarction and in 63% of patients with posterolateral MI 12 months after PCI, signs of LV inferiority were revealed in the form of an increase in the indices of end-diastolic and systolic volumes of the LV and low ejection fraction (≤45%). In patients without diabetes, these figures were 18% and 31%, respectively. High concentrations of NT-proBNP on the first day of myocardial infarction after PCI were of the greatest value in the diagnosis and prognosis of LV UR after 12 months.Conclusion. The NT-proBNP level of more than 776 pg/ml on the first day after PCI is an indicator of an unfavorable long-term prognosis in patients with young and middle-aged diabetes in terms of the development of LV systolic dysfunction.

scholarly journals Treatment Outcomes of Clopidogrel in Patients With ACS and Diabetes Undergoing PCI-analysis of Beijing Medicare Database

2020 ◽  
Author(s):  
Weihao Wang ◽  
Xiaoxia Wang ◽  
Lina Zhang ◽  
Jie Zhang ◽  
Fuli Man ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Large Scale ◽  
Coronary Intervention ◽  
Chinese Patients ◽  
Increased Risk ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
One Year ◽  
Medicare Database

Abstract Background There are several clinical trials that proved the efficacy of clopidogrel treatment for patients with percutaneous coronary intervention. There are few large-scale research to explore the mortality associated with different duration use of clopidogrel in patients with diabetes and ACS undergoing PCI in the Chinese population. Objectives The objective of this analysis was to determine the efficacy of long-term clopidogrel therapy(≥ 12 months) versus short-term use(< 12 months) in Chinese patients with diabetes after PCI. Methods Using the Beijing Medicare database provided by Beijing Medical Security Bureau. The Beijing Medicare database contains medical data of about 16 million people, including about 990,000 patients with diabetes and a history of taking antidiabetic medicines. Patients were divided into two groups, one group of 9,116 patients receiving consecutive clopidogrel for one year or more, and another group of 3290 patients receiving consecutive clopidogrel less than one year. The primary of this analysis was the risk of all-cause death, myocardial infarction and revascularization. Results In patients with diabetes after PCI, long-term clopidogrel treatment was associated with a reduced risk of all-cause death(HR, 0.57[95%CI, 0.49–0.67], P < 0.0001), myocardial infarction(HR, 0.79[95%CI, 0.68–0.93], P = 0.0035) and an increased risk of angina(HR, 1.18[95%CI, 1.10–1.27], P < 0.0001]) and revascularization(HR, 1.07[95%CI, 1.01–1.13], P = 0.02]). There was no significant difference in the incidence of all-cause re-hospitalization(P = 0.7529), diabetes-related re-hospitalization and cerebrovascular re-hospitalization. Conclusion The present study concluded that long-term dual anti-platelet therapy including clopidogrel and aspirin could decrease the risks of all-cause death, myocardial infarction. But it could increase the risks of angina and revascularization. Further studies should interpret the cause of this question.

Ticagrelor versus prasugrel in diabetic patients with an acute coronary syndrome

2014 ◽  
Vol 111 (02) ◽  
pp. 273-278 ◽  
Author(s):  
Marc Laine ◽  
Corinne Frere ◽  
Richard Toesca ◽  
Julie Berbis ◽  
Pierre Barnay ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Acute Coronary Syndrome ◽  
Platelet Reactivity ◽  
Statistical Significance ◽  
Randomised Trial ◽  
Diabetic Patients ◽  
Loading Dose ◽  
Open Label ◽  
Coronary Syndrome ◽  
Patients With Diabetes

SummaryOptimal P2Y12 receptor blockade is critical to prevent ischaemic recurrence in patients undergoing percutaneous coronary intervention (PCI). We aimed to compare the level of platelet reactivity (PR) inhibition achieved by prasugrel and ticagrelor loading dose (LD) in diabetic acute coronary syndrome (ACS) patients undergoing PCI. We performed a single-center prospective open-label randomised trial. Patients with diabetes mellitus undergoing PCI for an ACS were randomised to receive prasugrel 60 mg or ticagrelor 180 mg. The primary endpoint of the study was the level of platelet reactivity (PR) assessed between 6 and 18 hours post-LD using the VASP index. We randomised 100 diabetic patients undergoing PCI for an ACS. No difference was observed in baseline characteristics between the two groups. In particular, the rate of patient receiving insulin therapy was identical (25 vs 28.6%; p =0.7). Ticagrelor achieved a significantly lower PR compared to prasugrel loading dose (17.3 ± 14.2 vs 27.7 ± 23.3%; p=0.009). In addition the rate of high on-treatment platelet reactivity, defined by a VASP ≥50%, tend to be lower in the ticagrelor group although the difference did not reach statistical significance (6 vs 16%; p=0.2). The rate of low on treatment PR was identical (60 vs 54%; p=0.8). The present study demonstrates that ticagrelor LD is superior to prasugrel LD to reduce PR in ACS patients with diabetes mellitus. Whether the higher potency of ticagrelor could translate into a clinical benefit should be investigated.

scholarly journals One year prognosis of young Middle Eastern patients undergoing percutaneous coronary interventions

2016 ◽  
Vol 5 (1) ◽  
pp. 257
Author(s):  
Zayd I. Alhaddad ◽  
Rawan A. Hammoudeh ◽  
Rinad R. Tabbalat ◽  
Yousef Khader ◽  
Imad A. Alhaddad ◽  
...  
Keyword(s):  
Adverse Events ◽  
Older Patients ◽  
Coronary Revascularization ◽  
Middle Eastern ◽  
Young Patients ◽  
Coronary Intervention ◽  
Coronary Syndrome ◽  
Major Cardiovascular Events ◽  
Percutaneous Coronary ◽  
One Year

Background: There is scarcity of data about the outcome in young Middle Eastern patients who undergo percutaneous coronary intervention (PCI). We sought to assess clinical and coronary angiographic features and one year outcome of young compared with older patients following PCI.Methods: Baseline clinical and coronary angiographic features and major cardiovascular events from hospital admission to one year were assessed in young patients (<45 years of age) compared with older patients (>45 years of age).Results: Of 2426 patients; 308 (12.7%) were young. Young and older patients were predominantly males (76.3% vs. 79.8%; p=0.18) and had similar prevalence of hypertension, diabetes, dyslipidemia, and cigarette smoking. There were no differences between young and older patients in the rates of acute coronary syndrome as an indication for PCI (75.6% vs. 76.1%; p=0.90). The two groups had similar prevalence of one-vessel coronary artery disease (55.2% vs. 58.1%; p=0.37) and intervention for one vessel (74.0% vs. 72.1%; p=0.53). No significant differences were observed in the incidence of in-hospital adverse events in young compared with older patients. Incidence of adverse events in young patients at one year were not different from those in older patients, including cardiac death (3.63% vs. 2.11%), stent thrombosis (3.63% vs. 2.08%), major bleeding (1.30% vs. 1.18%), and coronary revascularization (3.65% vs. 3.24%); all p=NS.Conclusions: Among Middle Eastern patients undergoing coronary intervention; 13% were 45 years of age or younger. No favourable risk profile, coronary angiographic features or cardiovascular outcome were observed in young compared with older patients.

scholarly journals Incidence and Outcomes of Patients with Peri-Procedural Creatine Kinase (CK-MB) Elevation

2016 ◽  
Vol 01 (03) ◽  
pp. 020-025
Author(s):  
S Gundam ◽  
K. Saibaba
Keyword(s):  
Creatine Kinase ◽  
Chronic Stable Angina ◽  
Total Mortality ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Type B ◽  
Coronary Syndrome ◽  
Upper Limit ◽  
One Year ◽  
Enzyme Elevation

AbstractAims: Peri-procedural myocardial infarction (MI) is not an uncommon complication of percutaneous coronary intervention (PCI). We investigated the incidence and clinical outcomes of patients with peri-procedural creatine kinase elevation over one year followup.Methods: We prospectively evaluated the consecutive patients undergoing PCI either with acute coronary syndrome (ACS) or chronic stable angina (CSA) as presentation in our unit from July 2014 to December 2015. The term enzymatic infarct (EI) is used to include all patients with peri-procedural CK-MB elevation more than upper limit of normal (ULN). These patients are divided into three categories based on level of enzyme elevation and type of presentation. Type A includes those with CK-MB between 1 to 3 times the ULN, type B includes true peri-procedural MI that means CK-MB >3 times ULN, type C includes patients with baseline CK-MB elevation due to acute MI. We used the PMI definition from the third universal definition of MI: creatine kinase (CK-MB)>3 times upper limit of normal. We followed them up to one year for the major adverse cardiovascular events (MACES) and other complications. We compared the mortality rate between peri-procedural enzymatic infarct group and non peri-procedural enzymatic infarct patients along with incidence of peri-procedural EI in CSA versus ACS subgroups and tested for the significance.Results: Out of total 748 patients who undergone PCI in our unit, the total incidence of peri-procedural EI was 7.7%. Among total 58 peri-procedural EI events, 23(3%) were in patients with ACS presentation (p=0.001) and 34(4.5%) were in patients with CSA presentation (p=0.0001). Patients with peri-procedural EI had significantly higher risk of mortality than those without peri-procedural EI (5.1% versus 0.2%, p= 0.001). In subgroup analysis among patients with peri-procedural EI the mortality is higher in patients with ACS presentation compared to those with CSA as presentation (8.6% versus 2.9%(p=0.01)), and the total mortality is confined to the type B enzymatic infarct group.Conclusion: Among patients undergoing PCI, the occurrence of peri-procedural EI measured by CK-MB mass assay was 7.7% and Peri-procedural EI type B was associated with significant increase in mortality over one year followup.

Analysis of the relationship between different prognosis factors in patients with advanced colon cancer and progression-free survival.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15518-e15518
Author(s):  
Eduardo Richardet ◽  
Ignacio Magi ◽  
Luciana Paola Acosta ◽  
Maria gimena Ferreira ◽  
Matias Molina ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Statistical Significance ◽  
Progression Free Survival ◽  
Free Survival ◽  
Advanced Colon Cancer ◽  
Number Of Patients ◽  
Significant Difference ◽  
One Year ◽  
The Relationship

e15518 Background: Colon tumors are a heterogeneous group of disease. As a result of the accumulation of different genetic and epigenetic alterations, the mutation of the RAS, BRAF oncogene and microsatellite instability stands out. A new line of research are immunological and inflammatory factors, the infiltrating lymphocytes of the tumor stroma (TILs) and the neutrophil to lymphocyte radio (NLR) have been studied by our work team. We understood could that these factors were associated with the survival rate in our patients. The main objective of this reseach is to determine the relationship between NLR and progression-free survival (PFS) in patients with advanced colon cancer. Secondary objective is to determine the relationship between the location of the primary tumor, RAS status, TILs, and PFS. in the same group of patients. Methods: A total of 93 medical records of patients with advanced colon cancer was analyzed. Those pts who had recieved first-line chemotherapy treatment with a FOLFOX scheme plus a monoclonal antibody were included. All patients had to have a minimum follow-up of 12 months. Regarding NLR, the patients were classified into two groups: high ( = > 4) and low ( < 4). Four TILs cut-off points were determined: > 40% intense; between 11-40% moderate, 1-10% mild, and 0% absent, which were group into two categories: intense and moderate; slight and absent. Localization was divided into left and right, and KRAS status was divided into mutated and wild-type (WT). PFS was calculated using the Kaplan-Meier test. Results: The median PFS of the general population was 8.74 (7.39-11.07) months. The median PFS was 9.86 (7.82-13.41) vs 5.09 (4.43-10.84) months for low and high NLR respectively, with statistical significance (p: 0.01). When the percentage of patients without progression after one year of treatment was analyzed, the difference was 45% vs 14% in favor of NLR < 4 on ≥4, this difference was also statistically significant (p: 0.02). PFS in relation to TILs after one year of follow up was 33% (8.61 months) for moderate-intense infiltrate vs 30% of mild-absent (7.10 months). PFS was 9.79 months for KRAS WT pts vs 7.82 months for mutated KRAS. In terms of location, PFS was 9.79 months for the left colon vs 8.28 months for the right colon. These factors did not have a statistically significant difference. Conclusions: The results of the study show how NLR < 4 is a prognostic factor with a positive impact on PFS. It should be noted that the median survival rates were numerically higher in moderate-intense vs mild-absent TILs, also in KRAS WT vs mutated and in left vs right location. It should also be noted that the possibly there was not a statistically significant difference between them due to the limited number of patients per what we will continue working on in the recruitment and analysis of these patients.

STUDY ON LEVEL OF ANTI GAD AND ICA AUTOANTIBODIES IN PATIENTSWITH DIABETES MELLITUS

2016 ◽  
pp. 78-85
Author(s):  
Thi Minh Phuong Phan ◽  
Dinh Thanh Truong
Keyword(s):  
Diabetes Mellitus ◽  
Statistical Significance ◽  
Enzyme Linked Immunosorbent Assay ◽  
Acid Decarboxylase ◽  
Diabetic Patients ◽  
Significant Difference ◽  
Patients With Diabetes ◽  
Positive Rate ◽  
The Difference ◽  
The One

Background: Autoantibodies anti GAD and ICA associated to the autoimmune process of patients with diabetes. Detection of these antibodies in progessive diabeticpatients is very necessary because the presence of anti GAD and ICA can predict the progression of the disease to insulin-dependent diabetes in the future. This study was carried out with aims: (1) to define the positive rate, anti GAD and ICA level in patients with diabetes. (2) to evaluate the correlation between anti GAD and ICA with several clinical and paraclinical features of diabetic patients. Materials and method: 88 patients diagnosed of diabetes by the criteria of ADA 2014, withfasting glucose ≥ 126 mg/dL or≥ 7,0 mmol/L) and HbA1C> 6.5%. Indirect enzyme linked immunosorbent assay (ELISA) was used to measure those autoantibodies of anti GAD and ICA, kits were supplied by DRG company, Germany. Results: the anti GAD positive rate was 10.2%; mean of level of anti GAD was 1.44±0.25 U/mL. ICA positive ratewas 9.1%; mean of level of ICA was 1.44±0.12 U/mL. Positive rate with anti GAD and/or ICA was 19.3%. About the correlation between level of anti GAD, ICA with some of clinical features, we found only the statistically significant difference with p<0.05 between blur vision in the group of ICA level > 1.25U/mL with group of ICA level< 1.25U/mL. About the paraclinical features, the difference with statistical significance (p<0.05) of HbA1C>6.5% was found between the group with anti GAD> 1.05U/mLand the one with anti GAD< 1.00U/mLand also betweenthe group of ICA > 1.25 U/mL and ICA < 1.25 U/mL. Key words: autoantibody anti glutamic acid decarboxylase, islet cell autoantibodies, diabetes mellitus.

scholarly journals Percutaneous Coronary Intervention in Diabetic Patients

2020 ◽  
Author(s):  
Carolina Espejo Paeres ◽  
Breda Hennessey ◽  
Manel Sabaté ◽  
Pilar Jimenez-Quevedo
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Percutaneous Coronary ◽  
Patients With Diabetes ◽  
Main Determinants ◽  
Artery Disease ◽  
One Year

Cardiovascular disease (CVD) is responsible for 30% of deaths worldwide and is the leading cause of premature mortality in patients with diabetes mellitus (DM). One of the main contributors to the increased atherothrombotic risk in DM patients relates to their pro- inflammatory and prothrombotic status that involves abnormalities in endothelial and vascular smooth muscle cells, in platelet function and the coagulation cascade. The characteristics of CAD in diabetic patients is distinctive and infers an increased risk. Likewise, CAD in diabetics is characterised by being diffuse, affecting the left main stem more frequently, involving multiple vessels, and also affecting the distal coronary tree. Percutaneous coronary intervention in diabetics has been shown to have less favourable long-term clinical outcomes, compared to non-diabetics. With the advent of improved stent designs and antiplatelet drugs; the percutaneous coronary intervention (PCI) results have improved in the diabetic population. However, one of the main determinants of poorer outcomes in DM is the progression of atherosclerosis, which is more pronounced in diabetics and remains the primary cause of cardiac events at one year follow up after percutaneous revascularisation. Whilst new generation of drug-eluting stents has narrowed the gap between surgery and PCI in diabetic patients, coronary artery bypass grafting (CABG) remains the gold standard in diabetics with diffuse multivessel coronary artery disease.

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