In patients undergoing drug-coated balloon PCI, diabetes increased the risk of cardiac death, TVR, or target vessel MI compared to non-diabetics (adjusted HR 1.87; 95% CI 1.10-3.17).
Cohort (n=853)
Does diabetes increase the risk of adverse cardiovascular events in patients undergoing drug-coated balloon PCI compared to non-diabetic patients?
In an all-comers population undergoing drug-coated balloon PCI, diabetes is independently associated with a nearly two-fold increased risk of mid-term major adverse cardiovascular events and target lesion revascularization.
Hazard Ratio: 1.87 (95% CI 1.1–3.17)
Absolute Event Rate: 21.3% vs 10.6%
p-value: p=0.007
Background: Diabetes accelerates atherosclerosis and restenosis and impairs vascular healing, complicating percutaneous coronary intervention (PCI). Drug-coated balloons (DCBs) deliver antiproliferative therapy without a permanent scaffold, but their comparative mid-term performance in diabetic patients relative to non-diabetic patients is incompletely defined. Methods: We analysed a large all-comers cohort of consecutive patients who underwent a DCB-based PCI between 2018 and 2022, stratified by diabetes status. The primary endpoint was a composite of cardiac death, target vessel revascularisation (TVR) and target vessel myocardial infarction. Cumulative incidence was estimated by Kaplan–Meier analysis, and predictors were assessed by Cox regression. Results: Among 853 patients (304 diabetic, 549 non-diabetic), diabetic patients had more comorbidities and more frequent in-stent restenosis (52.3% vs. 41.8%). Over a median follow-up of 376 days, the two-year incidence of the composite endpoint was higher among diabetic patients (21.3% vs. 10.6%, p = 0.007), as was target lesion revascularisation (TLR; 13.6% vs. 5.5%, p = 0.004). Diabetes independently predicted the composite endpoint (adjusted hazard ratio: 1.87; 95% CI: 1.10–3.17) and TLR (adjusted HR: 2.33; 95% CI: 1.18–4.62), whereas DCB type and procedural variables did not. Conclusions: In an all-comers DCB-PCI population, diabetes was independently associated with higher rates of mid-term major adverse cardiovascular events and target lesion revascularisation, while device and procedural variables did not drive outcomes, underscoring the importance of systemic risk management in regard to diabetic patients.
Sticchi et al. (Sat,) conducted a cohort in Coronary artery disease requiring percutaneous coronary intervention (n=853). Diabetes vs. Non-diabetic patients was evaluated on Composite of cardiac death, target vessel revascularisation (TVR) and target vessel myocardial infarction (adjusted HR 1.87, 95% CI 1.10-3.17, p=0.007). In patients undergoing drug-coated balloon PCI, diabetes increased the risk of cardiac death, TVR, or target vessel MI compared to non-diabetics (adjusted HR 1.87; 95% CI 1.10-3.17).