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Initial outcomes of coronary angioplasty in diabetic patients
S Srimahachota1, S Boonyaratavej, W Udayachalerm
1Cardiac Center, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Insights
Diabetic patients undergoing percutaneous coronary angioplasty (PTCA) showed similar initial outcomes and major adverse cardiac events compared to non-diabetic patients. Despite demographic differences, diabetes did not significantly impact PTCA success rates or mortality.
Area of Science:
- Cardiology
- Interventional Cardiology
- Diabetology
Background:
- Diabetes mellitus is a significant risk factor for coronary artery disease (CAD).
- Diabetic patients often experience poorer prognoses following coronary revascularization procedures.
- Limited prospective data exists on the outcomes of diabetic patients undergoing percutaneous coronary angioplasty (PTCA) in Thailand.
Purpose of the Study:
- To compare the demographic characteristics of diabetic (DM) versus non-diabetic (non-DM) patients undergoing PTCA.
- To evaluate and compare the initial clinical outcomes between DM and non-DM patients post-PTCA.
- To assess major adverse cardiac events (MACE) and mortality rates in both groups.
Main Methods:
- Prospective study conducted in Thailand from January 1993 to December 1998.
- Data collected from 812 patients (280 DM, 532 non-DM) undergoing PTCA.
- Demographic data, procedural details, and in-hospital outcomes were recorded.
Main Results:
- Diabetic patients were more likely to be female, older, less likely to smoke, and had higher rates of dyslipidemia and hypertension.
- Key procedural factors like left ventricular ejection fraction, PTCA indication, vessel size, and number of diseased vessels were similar between groups.
- Case success rates (93.9% DM vs. 92.3% non-DM), in-hospital mortality (0.7% DM vs. 0.6% non-DM), and MACE (1.4% DM vs. 1.9% non-DM) were not significantly different.
Conclusions:
- While demographic differences exist between diabetic and non-diabetic patients undergoing PTCA, initial outcomes are comparable.
- PTCA demonstrates similar efficacy and safety in diabetic and non-diabetic populations regarding success rates, MACE, and mortality.
- This study provides valuable prospective data from Thailand on PTCA outcomes in diabetic patients.
Abstract:
Diabetes is one of the controllable risk factors of coronary artery disease. Many reports have shown that diabetes is a poor prognostic indicator for coronary events and revascularization among patients who undergo PTCA or coronary artery bypass surgery. The present work, the first prospective study in Thailand, was conducted to compare the demographic data and initial outcomes of diabetic patients (DM) with those of non-diabetic ones (non-DM) who underwent percutaneous coronary angioplasty (PTCA). Data between January 1993 and December 1998 were prospectively collected after each procedure and before discharge. During the 6-year period, 812 patients (DM-280, non-DM-532) were enrolled. The DM group had significantly more female patients (45.4 vs 21.1%, p < 0.0001), older age (62.5 +/- 8.2 vs 60.5 +/- 10.8 y, p < 0.007), less smoking (21.8 vs 43.2%, p < 0.0001), more dyslipidemia (56.8 vs 41.9%, p < 0.0001) and a higher incidence of hypertension (51.8 vs 42.5%, p = 0.01). The left ventricular ejection fraction, indication for PTCA, size of attempted vessel, and number of diseased vessels were similar in both groups. The case success rate was 93.9 per cent in the DM group and 92.3 per cent in the non-DM group (P=NS). Two patients (0.7%) in the DM and three cases (0.6%) in the non-DM group died during hospitalization. Overall major adverse cardiac events were not different between both groups (1.4 vs 1.9%, P =NS). In conclusion, there were some demographic differences in DM compared with non-DM patients who undergo PTCA; but initial outcomes, major adverse cardiac events, and mortality rates were not significantly different.
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