Predictors of long-term outcome following percutaneous coronary intervention in patients with type 2 diabetes mellitus

In Brief Objectives Diabetes has a major impact on the long-term outcome following percutaneous coronary intervention, being a major risk factor for restenosis. We aimed at assessing the clinical, hemodynamic and angiographic factors that predict outcome in this high-risk group. Methods Diabetic patients who underwent percutaneous coronary intervention during the period 1996–2000 were identified retrospectively, and their medical records, hemodynamic data and angiograms studied at the time of their procedure. Angiographic data were analyzed to determine procedural factors, quantitative angiographic results of their percutaneous coronary intervention and severity and extent scores of coronary artery disease. Clinical follow-up was obtained in 99.7% to a mean time of 782±153 days after percutaneous coronary intervention. Results A total of 327 consecutive diabetic patients underwent percutaneous coronary intervention on 389 lesions. The overall procedural success rate was 96.2%; however, during follow-up, 40.2% of patients had an adverse cardiac event. The strongest independent predictors of adverse outcome were presence of renal disease, need for medical diabetic treatment, and the extent of coronary artery disease as assessed by the extent score, but not the duration of diabetes or glycemic control. Other factors, which are often predictive of short-term outcome in a general population, such as vessel diameter, lesion length, and severity of coronary artery disease, were not predictive of outcome. Conclusions In patients with type 2 diabetes mellitus, the extent of the coronary arteries involved with atheroma as well as systemic factors such as renal involvement are the best predictors of long-term outcome following percutaneous coronary intervention. Diabetes is a major risk factor for adverse outcomes following percutaneous coronary intervention. We aimed to assess which factors predict outcome in this high-risk group. In 327 diabetic patients (389 lesions), clinical, hemodynamic and angiographic data were analyzed and clinical follow-up obtained. The overall procedural success rate was 96.2%; however, 40.2% of patients had an adverse cardiac event during follow-up. The strongest independent predictors of adverse outcome were presence of renal disease and the extent of coronary artery disease as assessed by the extent score, but not the duration of diabetes or glycemic control. Other factors, which are often predictive of short-termoutcome in a general population, such as vessel diameter and lesion length, were not predictive of outcome, suggesting that the extent of coronary atheroma rather than intervention itself is most important in long-termoutcome.