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Impact of diabetes mellitus on clinical outcomes after first episode in-stent restenosis PCI: Results from a large registry.

Authors :
Tanner, Richard
Farhan, Serdar
Giustino, Gennaro
Sartori, Samantha
Feng, Yihan
Hooda, Amit
Vinayak, Manish
Dangas, George
Mehran, Roxana
Kini, Annapoorna S.
Sharma, Samin K.
Source :
International Journal of Cardiology. Apr2024, Vol. 401, pN.PAG-N.PAG. 1p.
Publication Year :
2024

Abstract

Diabetes mellitus (DM) is associated with a high rate of major adverse cardiac events (MACE) after de novo coronary artery percutaneous coronary intervention (PCI). Whether patients with DM undergoing PCI for in-stent restenosis (ISR) experience a similar heightened risk of MACE is not known. Hence, we sought to compare the clinical outcomes of patients with and without DM undergoing PCI for ISR. Patients undergoing first episode ISR PCI between January 2015 and December 2021 were included. The primary outcome of interest was MACE (all-cause death, myocardial infarction [MI], and target lesion revascularization [TVR]) at 1-year. A total of 3156 patients (56.7% with DM) underwent PCI for ISR during the study period. Patients with DM were younger, more likely to be female, and had a higher prevalence of comorbidities. At 1-year follow-up, DM was associated with a higher rate of MACE (22.4% vs. 18.7%, unadjusted HR 2.03, 95%CI(1.27–3.25), p = 0.003). All-cause mortality and MI were significantly more frequent among people with DM at 1-year follow-up. The rate of TVR was similar in both groups (17.9% vs. 16.0%, unadjusted HR 1.14, 95%CI (0.94–1.37), p = 0.180). On adjusted analysis, there was no significant difference in the rate of MACE (AHR 1.07, 95%CI(0.90 ‐ –1.29), p = 0.444), all-cause death (AHR 1.54, 95%CI(0.93–2.54), p = 0.095) or MI (AHR 1.10, 95%CI(0.74–1.63), p = 0.652). ISR PCI in patients with DM was associated with a higher rate of MACE at 1-year follow-up. However, this increased risk was no longer significant after adjusting for baseline characteristics. • First episode In-stent-restenosis (ISR) PCI = high risk of major adverse cardiac events (MACE) at 1-year. • Diabetes mellitus = higher crude risk of MACE & all-cause death after ISR PCI. • Diabetes mellitus ≠ higher risk of target vessel revascularization after ISR PCI. • Diabetes mellitus ≠ independent predictor of MACE or TVR at 1 -year after ISR PCI. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
01675273
Volume :
401
Database :
Academic Search Index
Journal :
International Journal of Cardiology
Publication Type :
Academic Journal
Accession number :
175792231
Full Text :
https://doi.org/10.1016/j.ijcard.2024.131856