Abstract 2827: Impact of Diabetes Mellitus on the Long-Term Outcomes in Patients with Drug-Eluting Stent Implantation
Background Data are limited regarding the influence of diabetes on the long-term effectiveness and safety of drug-eluting stents (DES).
Methods This study compares the long-term outcomes of 865 diabetic patients to 3,160 non-diabetic patients treated with DES. The primary endpoint was the composite of death, myocardial infarction (MI), or target vessel revascularization (TVR). The incidence of stent thrombosis was also assessed by Academic Research Consortium (ARC) criteria.
Results Diabetic patients had a significant higher risk profile than non-diabetic patients (old age, a higher incidence of hypertension, renal failure, previous bypass surgery, complex lesions, and multivessel disease, and longer stent length). After risk adjustment, there was no difference in the overall risk of death (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.49 –1.11) or MI (HR 1.06; 95% CI, 0.50 –2.22) up to 3 years. However, there was a significant increase of TVR in diabetic patients, as compared with non-diabetic patients (10.5% vs. 3.8%, HR 2.34; 95% CI, 1.47–3.74; P<0.001). During 3 year, the incidence of the primary end-point was significantly higher in diabetic patients (16.3% vs. 10.4%, HR 1.64; 95% CI, 1.27–2.11; P<0.001). The incidence of stent thrombosis was similar between diabetic and non-diabetic patients (definite or probable; HR 0.85; 95% CI, 0.34 –2.08 and any ARC criteria; HR 1.11; 95% CI, 0.64 –1.94).
Conclusions Diabetes has a significant detrimental effect on the long-term outcomes, especially repeat revascularization, of patients treated with DES. The risk of stent thrombosis was similar in these patients without regard to the presence of diabetes.