Impact of diabetes and acute coronary syndrome on survival in patients treated with drug-eluting stents

Catheter Cardiovasc Interv. 2008 Dec 1;72(7):909-14. doi: 10.1002/ccd.21795.

Abstract

Background: Diabetics who undergo percutaneous coronary intervention (PCI) are at increased risk for death, myocardial infarction, repeat revascularization, and stent thrombosis.

Methods: Our retrospective study includes 887 consecutive patients who underwent PCI with drug-eluting stents (DES) at UCLA Medical Center. The cohort was divided into four groups: group 1, no diabetes and no acute coronary syndrome (ACS); group 2, no diabetes and ACS; group 3, diabetes and no ACS; group 4, diabetes and ACS.

Results: Survival at 1 year was the lowest in diabetics who presented with ACS (90% in diabetics with ACS, 95% in diabetics without ACS, 95% in non-diabetics with ACS, and 96% in the non-diabetics without ACS, P = 0.03). At 1 year, age, diabetes, chronic renal insufficiency, ejection fraction, and myocardial infarction were identified as independent predictors for mortality.

Conclusion: In the DES era, diabetics who undergo PCI for ACS continue to have an excess risk of death and major adverse cardiac events at 1 year.

MeSH terms

  • Acute Coronary Syndrome / diagnostic imaging
  • Acute Coronary Syndrome / etiology
  • Acute Coronary Syndrome / mortality*
  • Acute Coronary Syndrome / therapy*
  • Age Factors
  • Aged
  • Angioplasty, Balloon, Coronary* / adverse effects
  • Angioplasty, Balloon, Coronary* / instrumentation
  • Angioplasty, Balloon, Coronary* / mortality
  • Coronary Angiography
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / mortality*
  • Coronary Artery Disease / therapy*
  • Diabetes Mellitus / mortality*
  • Drug-Eluting Stents*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Myocardial Infarction / etiology
  • Myocardial Infarction / mortality
  • Proportional Hazards Models
  • Registries
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / mortality
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke Volume
  • Time Factors
  • Treatment Outcome