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Short- and long-term results after multivessel stenting in diabetic patients

Roxana Mehran1, George D Dangas, Yoshio Kobayashi

  • 1Cardiovascular Research Foundation, Lenox Hill Heart and Vascular Institute, New York, New York 10022, USA.

Journal of the American College of Cardiology
|April 20, 2004
PubMed

Insights

Diabetic patients undergoing multivessel stenting had higher rates of in-hospital coronary artery bypass graft surgery (CABG), increased target lesion revascularization, and lower one-year survival compared to non-diabetic patients. Diabetes mellitus is an independent predictor of adverse outcomes post-stenting.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Diabetes Mellitus Management

Background:

  • Coronary artery bypass graft surgery (CABG) has historically shown decreased survival in diabetic patients compared to conventional angioplasty.
  • Multivessel stenting has emerged as an alternative, with studies indicating good procedural success and acceptable outcomes.

Purpose of the Study:

  • To evaluate the clinical outcomes of diabetic patients following multivessel stenting.
  • To compare outcomes across diabetic patients treated with oral agents versus insulin, and non-diabetic patients.

Main Methods:

  • A total of 689 patients with 1,639 native coronary lesions underwent multivessel stenting.
  • Patients were stratified into three groups: no diabetes mellitus (DM), DM treated with oral agents, and DM treated with insulin.

Main Results:

  • Procedural success was high. In-hospital CABG was significantly higher in insulin-treated diabetics (3.5%) compared to other groups (p=0.02).
  • Diabetic patients (oral agents or insulin) exhibited higher one-year target lesion revascularization rates (25-35%) versus non-diabetics (16%) (p<0.001).
  • One-year survival was lower in diabetic patients (85-86%) compared to non-diabetics (95%) (p<0.001). DM independently predicted mortality, myocardial infarction, and revascularization.

Conclusions:

  • Multivessel stenting demonstrates high technical success but carries increased risks for diabetic patients.
  • Diabetic patients, particularly those on insulin, face higher in-hospital CABG rates, more frequent revascularization, and reduced one-year survival.
  • Diabetes mellitus is a significant independent predictor of adverse clinical outcomes after multivessel stenting.
Abstract

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