Multivessel drug-eluting stenting and impact of diabetes mellitus--a report from the EVENT registry.
Publication/Presentation Date
6-1-2009
Abstract
OBJECTIVES: To compare clinical outcomes in patients with and without diabetes after multivessel percutaneous coronary intervention (PCI).
BACKGROUND: Diabetes is associated with significantly worse outcomes after multivessel PCI and coronary bypass surgery is recommended as the preferred option for these patients.
METHODS AND RESULTS: The Evaluation of Drug Eluting Stents and Ischemic Events registry is a multicenter evaluation of acute and 1 year outcomes in unselected patients undergoing PCI since approval of drug-eluting stents (DES). Major adverse cardiac events (MACE) were defined as all cause mortality, myocardial infarction, or repeat revascularization and rate was estimated by Kaplan-Meier method and compared using log-rank. The independent correlates of MACE were determined using Cox proportional hazards regression. Of 4,819 nonemergency native coronary DES procedures, 1,595 (33.1%) were in patients with diabetes and 722 (11.7%) involved >1 vessel. Of patients undergoing multivessel procedures, diabetes was present in 256 (35.5%). One year after multivessel PCI, MACE was similar for patients with or without diabetes (22.3% versus 21.2%, log-rank test P = 0.85). The independent correlates of 1 year MACE were female sex (Hazard ratio [HR], 1.58, 95% CI 1.14-2.20), ejection fraction (HR 0.74 per group [50%], 95%CI 0.59-0.94) and number of stents (HR 1.20 per stent, 95%CI 1.04-1.38) but not diabetes (HR 1.00, 95% CI 0.71-1.39).
CONCLUSIONS: Multivessel DES is performed commonly in patients with diabetes with outcomes at 1 year similar to patients without diabetes. Longer follow-up is required to more fully evaluate the safety and effectiveness of this strategy.
Volume
73
Issue
7
First Page
874
Last Page
880
ISSN
1522-726X
Published In/Presented At
Novack, V., Tsyvine, D., Cohen, D. J., Pencina, M., Dubin, J., Dehghani, H., Kleiman, N. S., & Cutlip, D. E. (2009). Multivessel drug-eluting stenting and impact of diabetes mellitus--a report from the EVENT registry. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 73(7), 874–880. https://doi.org/10.1002/ccd.21925
Disciplines
Medicine and Health Sciences
PubMedID
19180665
Department(s)
Department of Medicine
Document Type
Article