Clinical outcomes after percutaneous coronary intervention in patients with and without history of diabetes mellitus with different stent size

2020 ◽  
Author(s):  
Mohammad Javad Zibaeenezhad ◽  
Mehrab Sayadi ◽  
Seyyed Saeed Mohammadi ◽  
Soorena Khorshidi ◽  
Ehsan Hadiyan ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Clinical Outcomes ◽  
Stable Coronary Artery Disease ◽  
Coronary Intervention ◽  
Lesion Length ◽  
Diabetic Patients ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
Stent Length ◽  
History Of

Abstract Background There are different reports on the occurrence of post-revascularization outcomes of diabetic patients in previous studies. Lesion complexity, which is reflected in stent size, influences the occurrence of outcomes. The aim of the present study was to investigate the occurrence of clinical outcomes in patients with history of diabetes (hDM) after percutaneous coronary intervention (PCI) with emphasis on stent length and diameter. Methods In a retrospective single-center cohort approach, among patients with stable coronary artery disease who underwent PCI with first- and second-generation DES, subjects were included from 2003 until 2019. Outcomes including revascularization, myocardial infarction, and death, totally defined as major adverse cardiac events (MACE), were sought in follow-up phase. All the patients whether with and without hDM received aspirin and clopidogrel as DAPT for at least two years and one year, respectively. Results About 29% out of 1630 participants had hDM and 37.8% of patients who experienced MACE had hDM. Unlike age and time-to-event, there was significant difference in gender between hDM and non-hDM groups. However, no difference was seen in type of MACE between these two groups. Also, after adjusting confounder variables, there was no significant difference in MACE incidence between hDM and non-hDM groups with different stent length and diameter (different lesion length and diameter). Conclusions hDM did not affect MACE incidence significantly in different stent length and diameter. We think that using of DES supplemented by long term DAPT and tight control of glycemic status after PCI are the underlying reasons.

P6516The association between prior coronary artery bypass graft surgery and outcome after percutaneous coronary intervention (PCI): an observational study of 123,780 patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Beirne ◽  
K Rathod ◽  
A Jain ◽  
A Mathur ◽  
A Wragg ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Clinical Outcomes ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Intervention ◽  
Bypass Grafts ◽  
Percutaneous Coronary ◽  
History Of

Abstract Background Limited information exists regarding procedural success and clinical outcomes in patients with previous CABG undergoing percutaneous coronary intervention (PCI). We sought to compare outcomes in patients undergoing PCI with or without previous coronary artery bypass grafts (CABG). Methods This was an observational cohort study of 123,780 consecutive PCI procedures from the Pan-London (United Kingdom) PCI registry, from January 2005 to December 2015. The primary end-point was all-cause mortality at a median follow-up of 3.0 years (interquartile range 1.2–4.6 years). Results 12,641 (10.2%) patients had a history of previous CABG, of whom 29.3% (n=3,703) underwent PCI to native vessels and 70.7% (n=8,938) to bypass grafts. There were significant differences in the demographic, clinical, and procedural characteristics of these groups. The risk of mortality during follow-up was significantly higher in patients with prior CABG (23.2%) (p=0.0005) compared to patients with no history of prior CABG (12.1%) and was seen for patients who underwent either native vessel (20.1%) or bypass graft PCI (24.2%, p<0.0001). However, after adjustment for baseline characteristics, there was no significant difference in outcomes seen between the groups when PCI was performed in native vessels in patients with previous CABG (HR 1.02, 95% CI 0.77–1.34; P=0.89) but a significant increase in mortality among patients with PCI to bypass grafts (HR 1.33 95% CI 1.03–1.71, P=0.026). This was seen after multivariate adjustment and propensity matching. Figure 1. Kaplan-Meier Curves Conclusion Patients with prior CABG are older, with a greater comorbid burden and more complex procedural characteristics, but after adjustment for these differences clinical outcomes are similar to patients undergoing PCI without prior CABG. In these patients, native vessel PCI was associated with better outcomes compared to the treatment of vein grafts.

scholarly journals Impact of Intensive Glucose Control in Patients with Diabetes Mellitus Undergoing Percutaneous Coronary Intervention: 3-Year Clinical Outcomes

2020 ◽  
Vol 9 (8) ◽  
pp. 2464
Author(s):  
Jiesuck Park ◽  
Jung-Kyu Han ◽  
Mineok Chang ◽  
You-Jeong Ki ◽  
Jeehoon Kang ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Clinical Outcomes ◽  
Glucose Control ◽  
Lower Risk ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Intensive Glucose Control ◽  
Adverse Cardiovascular Event ◽  
Percutaneous Coronary

We investigated whether intensive glucose control after percutaneous coronary intervention (PCI) improves clinical outcomes in diabetic patients. From the Grand-DES registry, we analyzed 2576 diabetic patients (median age 66 years, male 65.6%) who underwent PCI and had at least 2 records of HbA1c during the follow-up. Patients were categorized according to the mean HbA1c (≥7% or <7%). Primary outcome was major adverse cardiovascular event (MACE), a composite of cardiac death, non-fatal myocardial infarction, and any revascularization. During a median follow-up of 33.6 months, MACE occurred in 335 (13.0%) patients. Intensive glucose control with follow-up mean HbA1c < 7.0% (42.2%; n = 1087) was not associated with lower risk of MACE, compared to control with mean HbA1c ≥ 7.0% (adjusted hazard ratio [aHR] [95% confidence interval] 1.06 [0.82–1.37], p = 0.672). In subgroup analysis, patients with sustained HbA1c of <7.0% throughout the follow-up were not associated with a lower risk of MACE compared to those with sustained HbA1c of ≥7.0% (aHR 1.15 [0.71–1.89], p = 0.566). More intensive glucose control with mean HbA1c ≤ 6.5% was not associated with lower risk of MACE, compared to loose control with a mean HbA1c ≥ 8.0% (aHR 1.15 [0.71–1.86], p = 0.583). Intensive glucose control after PCI was not associated with better clinical outcomes in diabetic patients undergoing PCI than lenient control.

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