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February 1, 2019MedicineOpen Access

In-hospital, short-term and long-term adverse clinical outcomes observed in patients with type 2 diabetes mellitus vs non-diabetes mellitus following percutaneous coronary intervention

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Why the study?

Does type 2 diabetes mellitus increase the risk of adverse clinical outcomes in patients undergoing percutaneous coronary intervention compared to patients without diabetes?

Population

139,774 patients following PCI

Comparison

Patients with T2DM vs patients without DM

Design

Meta-analysis of RCTs and observational studies

Follow-up

In-hospital, short-term (<1 year), and long-term (≥1 year)

Authors

XZXiaojun ZhuoCZChuanzeng ZhangJFJuan Feng

Discussion

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Member takes

Overview

Supports intensified peri-PCI monitoring for T2DM patients; confirms diabetes as a key adverse prognostic factor.

Structured PICO

Does type 2 diabetes mellitus increase the risk of adverse clinical outcomes in patients undergoing percutaneous coronary intervention compared to patients without diabetes?

P
Population
139,774 patients (40,053 with type 2 diabetes mellitus and 99,721 without diabetes mellitus) undergoing percutaneous coronary intervention (PCI), pooled from 42 randomized controlled trials and observational studies.
I
Intervention
Percutaneous coronary intervention (PCI) in patients with type 2 diabetes mellitus (T2DM).
C
Comparator
Percutaneous coronary intervention (PCI) in patients without diabetes mellitus.
O
Outcome
In-hospital, short-term (<1 year), and long-term (≥1 year) adverse clinical outcomes including mortality, myocardial infarction (MI), major adverse cardiac events (MACEs), stroke, bleeding, target vessel revascularization (TVR), target lesion revascularization (TLR), and stent thrombosis.hard clinical

Patients with type 2 diabetes mellitus have a significantly higher risk of in-hospital, short-term, and long-term adverse clinical outcomes, including mortality and MACEs, following PCI compared to patients without diabetes.

Limitations

  • Comorbidity status among patients with DM was not the same in all studies (e.g., included CTO, ACS, stable CAD, single and multi-vessel diseases).
  • Different types of MI (Q and non-Q wave, fatal and non-fatal, STEMI and NSTEMI) were combined and analyzed as one subgroup.
  • Types of stents (bare metal vs drug eluting) were not taken into consideration.
  • Duration of disease, blood sugar control status, and use of oral hypoglycemic or other cardiac medications were ignored.
  • Duration length of dual antiplatelet use was not taken into consideration.
  • Non-atherosclerotic fatty liver disease was not studied.

Cite This Study

Zhuo et al. (2019) studied this question.

synapsesocial.com/papers/6a823b89004fcf503374aaachttps://doi.org/10.1097/md.0000000000014669
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