Key result
Diabetes mellitus was associated with a higher 1-year rate of total MACEs compared to nondiabetics (10.3% vs 7.7%; OR 1.677, P=0.002) following PCI for chronic total occlusion.
Why the study?
The impact of diabetes mellitus on 1-year clinical outcomes after PCI for chronic total occlusion lesions was unclear.
Does diabetes mellitus increase the risk of 1-year adverse clinical outcomes in patients undergoing percutaneous coronary intervention for chronic total occlusion?
Cohort (n=2,865)
Does diabetes mellitus increase the risk of 1-year adverse clinical outcomes in patients undergoing percutaneous coronary intervention for chronic total occlusion?
Odds Ratio: 1.677
Absolute Event Rate: 10.3% vs 7.7%
p-value: p=0.002
Diabetes mellitus, particularly when requiring insulin, is an independent risk factor for 1-year target lesion revascularization and major adverse cardiac events after percutaneous coronary intervention for chronic total occlusion.
OBJECTIVE: This study aimed to compare 1-year clinical outcomes in diabetic and nondiabetic patients with chronic total occlusion (CTO) lesions. METHODS: A total of 2865 patients (age 62.82±10.64 years; 74.0% men) undergoing percutaneous coronary intervention for CTO were analyzed. The patients were classified as diabetic (n=977) or nondiabetic (n=1888). One-year clinical outcomes were compared between the two groups. RESULTS: One year after percutaneous coronary intervention, 241 (8.4%) patients developed major adverse cardiac events (MACEs). Target lesion revascularization (TLR), target vessel revascularization (TVR), TLR-MACEs, and total MACEs were more common in diabetics than in nondiabetics (6.1 vs. 3.9%, P=0.021; 7.2 vs. 4.8%, P=0.023; 7.7 vs. 5.5%, P=0.017; and 10.3 vs. 7.7%, P=0.011; respectively). In multivariate analysis, diabetes mellitus was an independent predictor for 1-year TLR (odds ratio: 2.201, P=0.001) and total MACEs (odds ratio: 1.677, P=0.002). Among diabetic patients, total death, TLR, TVR, TLR-MACEs, TVR-MACEs, and total MACEs were more common in patients who used insulin than in those who did not (6.1 vs. 1.9%, P=0.018; 11.3 vs. 4.6%, P=0.007; 12.2 vs. 5.9%, P=0.025; 14.8 vs. 5.9%, P=0.003; 16.5 vs. 8.0%, P=0.008; and 17.4 vs. 9.2%, P=0.012, respectively). Insulin use was an independent predictor for total death, 12-month TLR, TVR, TLR-MACEs, TVR-MACEs, and total MACEs. CONCLUSION: This study identified diabetes mellitus as an independent risk factor for 1-year TLR and total MACEs in patients with CTO lesions.
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Rha et al. (2015) conducted a cohort in Chronic total occlusion (CTO) (n=2,865). Diabetes mellitus vs. Nondiabetic was evaluated on Total major adverse cardiac events (MACEs) at 1 year (OR 1.677, p=0.002). Diabetes mellitus was associated with a higher 1-year rate of total MACEs compared to nondiabetics (10.3% vs 7.7%; OR 1.677, P=0.002) following PCI for chronic total occlusion.
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