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Analysis of recurrent revascularization events following percutaneous coronary intervention of diabetic patients

M Anselmino1, S Delcrè, C Moretti

  • 1Cardiology Unit, San Giovanni Battista, Molinette Hospital, University of Turin, Turin, Italy. matt.ans@alice.it

Minerva Cardioangiologica
|March 11, 2009
PubMed

Insights

Patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) often require repeat procedures. PCI may offer better protection against future coronary events than surgical revascularization in these high-risk patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Diabetology

Background:

  • Patients with diabetes mellitus (DM) have a higher risk of recurrent cardiovascular events after percutaneous coronary intervention (PCI).
  • The precise nature and frequency of these recurrent events require further elucidation.

Purpose of the Study:

  • To describe the frequency and characteristics of recurrent cardiovascular events after PCI in high-risk DM patients.
  • To compare the long-term impact of repeat PCI versus surgical revascularization on subsequent coronary interventions.

Main Methods:

  • A cohort of 254 consecutive DM patients undergoing PCI for coronary artery disease (CAD) was followed for 39+/-9 months.
  • Endpoints included target vessel PCI (TVR PCI), target vessel surgical revascularizations (TVR CABG), non-target vessel PCI (NON TVR PCI), and no repeat revascularizations.

Main Results:

  • 35% of DM patients required further revascularization after an initial PCI.
  • Repeat revascularization rates were similar after initial PCI or surgical intervention for lesions in previously treated epicardial vessels.
  • Surgical revascularization was associated with a higher likelihood of subsequent PCI for untreated lesions in other epicardial vessels.

Conclusions:

  • Percutaneous coronary intervention (PCI) may provide superior protection against disease progression in native coronary arteries compared to surgical revascularization in DM patients.
  • These findings suggest PCI might be more effective in preventing future coronary interventions in this population.
  • Larger studies are needed to confirm these results.
Abstract

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