Key result
Diabetes mellitus was not an independent predictor of 2-year all-cause mortality following percutaneous coronary intervention (OR 1.08; 95% CI 0.73-1.60; P=0.71).
Why the study?
Does diabetes mellitus independently predict 2-year mortality in patients undergoing contemporary percutaneous coronary intervention?
Cohort (n=5,759)
No
Does diabetes mellitus independently predict 2-year mortality in patients undergoing contemporary percutaneous coronary intervention?
Odds Ratio: 1.08 (95% CI 0.73–1.6)
Absolute Event Rate: 5.1% vs 3.8%
p-value: p=0.71
In a retrospective cohort of patients undergoing contemporary PCI with stenting, the presence of diabetes mellitus was not an independent predictor of 2-year all-cause mortality.
DM should not yet alter post-PCI risk models; leaves open whether contemporary stents have attenuated prior diabetes-related mortality excess.
OBJECTIVE: To assess the impact of diabetes on 2-year mortality in current PCI practice. BACKGROUND: In patients with coronary artery disease undergoing revascularization, diabetes mellitus is associated with higher mortality. METHODS: A retrospective analysis was done of all patients undergoing PCI at our tertiary center between January 2000 and December 2004. There were 6,160 PCI procedures performed in 5,759 patients who received at least one stent. Of these patients, 801 (13.9%) were diabetic and 4,958 (86.1%) were nondiabetic. The primary outcome measure of the study was all-cause mortality. All patients were followed up for a period of 2 years. Multivariate logistic regression analysis was used to test for a potential independent association between diabetic status and follow-up mortality. RESULTS: Before adjustment, a trend toward higher mortality was observed in diabetic patients compared to non-diabetics at 1 year (3.2% vs 2.4%) and 2 years (5.1% vs 3.8%), P = 0.12. Independent predictors for mortality were increasing age, renal dysfunction, peripheral vascular disease, NYHA class >2, urgent PCI, treating left main stem lesions, vessel diameter < or = 2.5 mm, and 3-vessel disease. The use of drug-eluting stent was associated with a reduction in mortality. Diabetes was found to have no independent impact on mortality following PCI (odds ratio = 1.08; 95% confidence intervals = 0.73-1.60; P = 0.71). CONCLUSION: The presence of diabetes was not an independent predictor of mortality following PCI. A diabetic patient that does not require insulin treatment and has no evidence of macro- or microvascular diabetic disease could enjoy a PCI outcome similar to nondiabetic subjects.
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Andron et al. (2009) conducted a cohort in Coronary artery disease undergoing PCI (n=5,759). Diabetes mellitus vs. Nondiabetic patients was evaluated on All-cause mortality (OR 1.08, 95% CI 0.73-1.60, p=0.71). Diabetes mellitus was not an independent predictor of 2-year all-cause mortality following percutaneous coronary intervention (OR 1.08; 95% CI 0.73-1.60; P=0.71).
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