Diabetes Mellitus Impact in Patients Undergoing Percutaneous Coronary Intervention

pp. 344-351

Abstract

Background: Diabetes mellitus (DM) has been associated with increased adverse outcomes in patients treated with percutaneous coronary intervention (PCI) compared with non-diabetic patients.

Objective: The aim of this study was to evaluate in a population of unselected patients treated with PCI, the risk of major adverse cardiac events (MACE) in diabetic patients stratified according to treatment (non-insulin dependent or insulin-dependent).

Methods: A retrospective, single center registry of patients with coronary artery heart disease treated with PCI was analyzed from March 2009 to June 2018 according to the presence of diabetes stratified into insulin-dependent DM (ID-DM) and non-insulin dependent DM (NID-DM), in line with the treatment received to control the metabolic disorder. An adjusted Cox regression model was applied to evaluate the relationship between the diabetic status and the risk of MACE.

Results: A total of 6,313 patients with mean follow-up of 4.1±1.8 years and a global prevalence of DM of 22.8% (NID-DM 19.1%, IDDM 3.8%) were included in the study. Diabetic patients showed a higher risk profile, particularly those with ID-DM. At mean followup time, the adjusted risk of MACE was similar between Non-DM and NID-DM patients (HR 1.02 [0.81–1.27], p=0.85). A higher risk of MACE was reported in ID-DM compared with Non-DM (HR 1.73 [1.20–2.49], p=0.003) and NID-DM (HR 1.65 [1.10–2.48], p=0.015) patients. A significant interaction was observed between the diabetic status and the risk of cardiovascular events according to the indication of PCI at admission (pint 0.045).

Conclusions: In our registry of patients undergoing PCI and with a long-term follow-up, diabetic patients presented a high risk of MACE. This risk was particularly increased in ID-DM patients. However, there were no significant differences in the risk of MACE between NID-DM and Non-DM patients.