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Interventional treatment in diabetics in the era of drug-eluting stents and compliance to the ESC guidelines: lessons learned from the Euro Heart Survey Programme
- Source :
- EuroIntervention, 4(5), 578-587. EuroPCR
- Publication Year :
- 2009
-
Abstract
- Aims: The objective of the study is to determine the demographics and the in-hospital outcome of diabetic and non-diabetic patients treated with percutaneous coronary interventions (PCI) in Europe, to report the type of equipment and technology used for PCI procedures in diabetics and to clarify whether the treatment of diabetic patients complies with current European Society of Cardiology (ESC) guidelines. Methods and results: A total of 14,458 patients treated with PCI were enrolled from 29 member countries of the ESC between June 2005 and January 2006. Data were collected on patient characteristics and treatment, using new Cardiology Audit and Registration Data standards. In total, 3,603 patients (24.9%) were diabetic. Diabetics were older, more often female and had a higher body mass index than non-diabetics. Diabetics had higher rates of hypercholesterolaemia and hypertension, while current smokers were more frequent in the non-diabetics. Diabetics also had significantly higher rates of previous cardiovascular events. Clopidogrel was administered only in 48.1% of diabetic patients before PCI, while IIb/IIIa inhibitors were 22.9% during PCI. At discharge, there was a major adjustment of treatment with increases in the use of Beta-blocker (80.4%), angiotensin converting enzyme inhibitor (ACEI, 71.3%) and statins (89.8%) compared with on admission (Beta-blocker 60.9%, ACEI 55.0%, statin 63.1%). Inhospital mortality was higher in diabetics (1.8% vs 1.2%) although the in-hospital MACCE rate was not significantly different (3.6% vs 3.0%, p=0.09). Conclusions: Diabetic patients treated with PCI were older with more comorbidity. According to ESC guideline, the under-usage of clopidogrel, GP IIb/IIIa inhibitors should be improved. PCI is now taken as a good opportunity to adjust the use of appropriate medication. © Europa Edition. All rights reserved.
- Subjects :
- Registrie
Male
medicine.medical_treatment
Angiotensin-Converting Enzyme Inhibitors
Comorbidity
Coronary Artery Disease
Severity of Illness Index
Cardiovascular Disease
Hospital Mortality
Registries
Angioplasty, Balloon, Coronary
Drug-Eluting Stents
Middle Aged
Clopidogrel
Europe
Treatment Outcome
Drug-eluting stent
Cardiovascular Diseases
Practice Guidelines as Topic
Female
Guideline Adherence
Inpatient
Cardiology and Cardiovascular Medicine
Human
medicine.drug
medicine.medical_specialty
Diabetic Angiopathie
Adrenergic beta-Antagonists
Diabetic
SDG 3 - Good Health and Well-being
Internal medicine
Diabetes mellitus
Angioplasty
medicine
Humans
Drug eluting stent
cardiovascular diseases
Risk factor
Aged
European Heart Survey
Inpatients
Clinical Audit
business.industry
Platelet Aggregation Inhibitor
Adrenergic beta-Antagonist
Angiotensin-Converting Enzyme Inhibitor
Guideline
medicine.disease
Surgery
Health Care Survey
Health Care Surveys
Conventional PCI
Hydroxymethylglutaryl-CoA Reductase Inhibitor
Hydroxymethylglutaryl-CoA Reductase Inhibitors
business
Diabetic Angiopathies
Platelet Aggregation Inhibitors
Subjects
Details
- ISSN :
- 1774024X
- Volume :
- 4
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- EuroIntervention
- Accession number :
- edsair.doi.dedup.....7c5884d7b0f74b42f4e387f2e28e645d