Abstract 15536: Impact of Diabetes Mellitus on Clinical Outcomes after Percutaneous Coronary Intervention with Drug-Eluting Stents for Unprotected Left Main Coronary Artery Disease
Introduction Few data is available on the comparison between diabetic and non-diabetic patients after percutaneous coronary intervention (PCI) with drug eluting stents for unprotected left main coronary artery disease.
Hypothesis We assessed the hypothesis that diabetes mellitus is a predictor of worse clinical outcome after PCI with drug eluting stents for unprotected left main disease.
Methods This is a multicenter registry enrolling consecutive patients undergoing PCI with paclitaxel or everolimus-eluting stents for unprotected left main disease. Death, cardiac death, myocardial infarction (MI), clinically-driven-target lesion revascularization (TLR), target vessel revascularization (TVR), stroke, definite/probable stent thrombosis were assessed at 2-year follow-up. A multiple cox regression analysis was performed. Hazard ratios (HR) with 95% confidence interval (CI) were calculated.
Results A total of 331 patients, median age 71 yrs-old, (25th-75th percentile 62-78), 87 (26.3%) diabetics, 172 undergoing paclitaxel eluting stent and 159 undergoing everolimus eluting stent implantation, were enrolled. At 2-year follow-up diabetics, as compared to non-diabetic patients, presented a higher incidence of death (14.9% vs 4.5%, p=0.001), cardiac death (9.2% vs 2.9%, p=0.015), stroke (5.7% vs 0.8%, p=0.015), definite/probable stent thrombosis (3.4% vs 0%, p=0.018), the composite of death/MI/stroke, (21.8% vs 9.8%, p=0.004), the composite of death/MI/TLR (22.9% vs 13.1%, p=0.03), and the composite of death/MI/TLR/stroke (25.3% vs 13.5%). No significant differences between diabetics and non-diabetic patients were found with respect to MI (10.3% vs 6.1%, p=0.19), TLR (6.9% vs 4.9%, p=0.48) or TVR (16.1% vs 9.4%, p=0.09). At multiple cox regression analysis, diabetes status was a significant predictor of death/MI/stroke (HR 2.39, 95% CI 1.30-4.37, p=0.005), of death/MI/TLR (HR 1.97, 95% CI 1.12-3.46, p=0.018) and of death/MI/TLR/stroke (HR 2.08, 95% CI 1.21-3.58, p=0.008).
Conclusions In patients undergoing PCI with drug eluting stents for unprotected left main coronary artery disease, diabetes status is associated with a significantly worse prognosis at 2-year follow-up.
- © 2012 by American Heart Association, Inc.