Abstract 16839: Thirty-Year Trends in in-Hospital and Long-Term Outcome of Percutaneous Coronary Interventions in Patients with Diabetes Mellitus: A Single Institution Experience
Background: Temporal trends are lacking characterizing the impact of diabetes mellitus (DM) on outcomes following percutaneous coronary interventions (PCI).
Methods: and Results Thirty year in-hospital and long-term outcome of 30,014 PCIs among 23,209 unique patients with (n=6908) and without DM (n=22,958) were analyzed. The Mayo Clinic study population was divided into 4 groups: Group 1 (n=3,558), 1979–1989; group 2 (n=7,511), 1990–1996; group 3 (n=11,259), 1996–2003; and group 4 (n=7,538), 2004–2008. In group 4, the procedural success (92.6% vs. 93.3%) and in-hospital mortality (2.1% vs.1.7%) were similar in patients with and without DM, however, long-term mortality, mortality or revascularization, and mortality, myocardial infarction (MI), or stroke were higher in patients with DM as compared to without DM. Despite patients with DM in groups 3 and 4 being older, hypertensives, heart failure, and previous revascularization than those in groups 1 and 2, procedural success in groups 3 (91.1%) and 4 (92.6%) improved significantly vs. groups 2 (56.1%) and 1 (28.9%), (P001). Significant reduction in in-hospital mortality (Fig) (groups 1 to 4: 4.2%, 4.4%, 2.0%, 2.1%, P001), and need for emergency CABG (groups 1 to 4: 8.2%, 1.7%, 0.9%, 0.6%, P001) was noted in groups 3 and 4 compared with groups 1 and 2. After adjustment, groups 3 and 4 had significantly better long-term outcomes than group 2 for death, hazard ratio (HR): 0.81 (p<0.001) and 0.67 (p<0.001), death/revascularization, HR: 0.88 (p=0.013) and 0.84 (p=0.010)) and death/MI/stroke, HR: 0.80 (p<0.001) and 0.76 (p<0.001)). Group 4 was also significantly better than group 3, HR. 0.82 (0.003) for long-term mortality.
Conclusions: Significant improvement in the in-hospital and long-term outcomes are noted in the last 3 decades in diabetics undergoing PCI. Diabetics undergoing PCI in the contemporary era have similar in-hospital but worse long-term outcomes as compared with non diabetics.
- © 2010 by American Heart Association, Inc.