Key result
Preexisting diabetes is linked to a ~70% higher risk of long-term post-PCI death.
Why the study?
The prevalence of diabetes in patients undergoing PCI and its impact on immediate and long-term outcomes in coronary artery disease patients was not well characterized.
Does preexisting diabetes worsen immediate and long-term mortality in patients undergoing percutaneous coronary intervention?
Cohort (n=18,155)
Yes
Does preexisting diabetes worsen immediate and long-term mortality in patients undergoing percutaneous coronary intervention?
Hazard Ratio: 1.7 (95% CI 1.1–2.6)
p-value: p=< 0.05
Diabetes is associated with more complex coronary lesions and significantly worse short- and long-term mortality in patients undergoing percutaneous coronary intervention.
Supports diabetes as long-term mortality marker post-PCI; leaves open whether targeted interventions improve survival.
Background: Cardiovascular diseases are the major leading cause of death globally out of which 7.4 million were due to coronary artery diseases.In diabetes patients, the prevalence of coronary artery disease is more common compare to general population.Objective: To identify the prevalence of diabetes in patients who underwent for percutaneous coronary intervention.To determine immediate and long term outcome of diabetes patients with significant coronary artery disease.Method: Retrospective analysis of national cardiovascular disease data from 2007-2013.Result: Total 18155 patients had undergone percutaneous coronary intervention.44% (7990) patients were known to have diabetes with mean age of 58 years.Male patients constitute 76.6% (6121).Hypertension was more commonly seen in diabetic patients (6825 -85.9%) compared to non-diabetic patients (6281-62%).Even though heart failure were more commonly associated in diabetic patients ( 5.1% vs 2.8%), lesser percentage of diabetic patients were on optimal heart failure medications.40.1% (3204) of diabetic patients were presented with acute coronary syndrome out of which 53.5% (1714) were ST elevation myocardial infraction.Ostial lesions were more commonly identified in diabetes patients (7.3% vs 6.6%).Immediate hospital outcome such as death and also cardiac deaths were more common in diabetes (0.7% and 0.4% respectively) compare to non-diabetes ones (0.4% and 0.2% respectively).In survival analysis for long term clinical outcome, hazard ratio is found out to be 1.7 ( 95% CI 1.1-2.6;p value < 0.05), indicating significant higher hazard of death in established coronary artery disease who are having diabetes compare to non-diabetes patients.Conclusion: In conclusion, in coronary artery disease patients who are having diabetes as preexisting co morbid carries more complex coronary angiogram findings as well as poor immediate in hospital outcome compare to non-diabetic patients.2 years follow up also identified lower survival rate in diabetes patients.
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A 2019 study conducted a cohort in Coronary artery disease requiring percutaneous coronary intervention (n=18,155). Diabetes vs. Non-diabetes was evaluated on Long-term death (HR 1.7, 95% CI 1.1-2.6, p=< 0.05). In patients undergoing percutaneous coronary intervention, preexisting diabetes was associated with a significantly higher hazard of long-term death compared to non-diabetic patients (HR 1.7; 95% CI 1.1-2.6; p<0.05).
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