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Coronary stenting in diabetic patients: Results from the ROSETTA registry
T Huynh1, M J Eisenberg, U Deligonul
1Montreal General Hospital, Montreal, Quebec, Canada. thao.huynh@muhc.mcgill.ca
Insights
Coronary stenting did not improve clinical event rates for diabetic patients undergoing percutaneous transluminal coronary angioplasty (PTCA). This study found no significant difference in adverse outcomes between stented and non-stented diabetic patients after PTCA.
Area of Science:
- Cardiology
- Interventional Cardiology
- Diabetology
Background:
- Diabetes mellitus is linked to higher restenosis and adverse outcomes post-percutaneous transluminal coronary angioplasty (PTCA).
- The benefit of coronary stenting in diabetic patients after PTCA remains uncertain.
Purpose of the Study:
- To evaluate if coronary stenting improves clinical event rates in diabetic patients following PTCA.
Main Methods:
- The study utilized data from the prospective, multicenter Routine Versus Selective Exercise Treadmill Testing After Angioplasty (ROSETTA) registry.
- Compared outcomes in 180 diabetic patients, with 90 receiving stents and 90 not, after successful PTCA.
Main Results:
- At 6-month follow-up, the composite endpoint (cardiac death, unstable angina, myocardial infarction, repeat PTCA, or CABG) occurred in 25.0% of stented and 22.2% of non-stented diabetic patients (P=NS).
- Multivariate analysis indicated coronary stenting was not associated with a reduced incidence of the composite endpoint in diabetic patients (OR 0.97, 95% CI 0.46-2.05, P=NS).
Conclusions:
- Coronary stenting does not appear to improve clinical event rates in diabetic patients after PTCA.
- Further research may be needed to explore alternative strategies for managing coronary artery disease in diabetic populations.
Objective:
Diabetes mellitus is associated with high rates of restenosis and adverse outcomes after percutaneous transluminal coronary angioplasty (PTCA). It is unclear whether coronary stenting reduces adverse events in diabetic patients after PTCA. Our purpose was to determine whether coronary stenting improves clinical event rates in diabetic patients after PTCA.
Methods:
The Routine Versus Selective Exercise Treadmill Testing After Angioplasty (ROSETTA) registry was a prospective multicenter observational study examining functional testing and adverse outcomes after successful PTCA.
Results:
Among the 791 patients enrolled, 180 were diabetic. A total of 90 diabetics received stents while the remaining 90 patients did not. Baseline clinical characteristics were similar between the 2 groups of patients. However, patients with stents were more likely to have complex lesions, whereas those without stents were more likely to undergo atherectomy and have greater residual coronary stenosis. At 6-month follow-up, the composite end point defined as cardiac death, unstable angina, myocardial infarction, need for repeat PTCA, or coronary artery bypass graft surgery (CABG) occurred in 25.0% of stented and 22.2% of nonstented diabetic patients (P not significant [NS]). A multivariate logistic regression analysis showed that coronary stenting was not associated with a reduced incidence of the composite end point among diabetic patients (odds ratio 0.97, 95% CI 0.46-2.05, P NS).
Conclusion:
Coronary stenting does not improve clinical event rates in diabetic patients after PTCA.