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Association of diabetes with outcomes in patients undergoing contemporary percutaneous coronary intervention:

Ply Chichareon1, Rodrigo Modolo2, Norihiro Kogame3

  • 1Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Meibergdreef 9, Amsterdam, the Netherlands; Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

Atherosclerosis
|February 2, 2020
PubMed

Insights

Diabetic patients face higher ischemic event risks after percutaneous coronary intervention (PCI). However, bleeding risks remain comparable, and outcomes are unaffected by different antiplatelet strategies in this patient group.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Diabetes Mellitus

Background:

  • Diabetes is a known risk factor for adverse outcomes post-percutaneous coronary intervention (PCI).
  • Conflicting data exists regarding diabetic patient outcomes in the era of drug-eluting stents and potent P2Y12 inhibitors.

Purpose of the Study:

  • To evaluate ischemic and bleeding outcomes in diabetic versus non-diabetic patients after contemporary PCI.
  • To assess the impact of different antiplatelet strategies on these outcomes.

Main Methods:

  • Analysis of 15,957 patients from the GLOBAL LEADERS study undergoing PCI.
  • Primary endpoint: all-cause death or new Q-wave myocardial infarction at 2 years.
  • Secondary safety endpoint: major bleeding (BARC type 3 or 5).

Main Results:

  • Diabetic patients (25% of cohort) had a significantly higher risk of the primary endpoint at 2 years (aHR 1.38).
  • Increased mortality risk was the main driver in diabetics (aHR 1.47).
  • Bleeding risk (BARC 3 or 5) was comparable between diabetic and non-diabetic groups (aHR 1.09).

Conclusions:

  • Diabetic patients exhibit an elevated risk of ischemic events post-PCI, but not increased bleeding risk.
  • The antiplatelet strategy did not significantly alter PCI outcomes for diabetic or non-diabetic patients.
Abstract

Keywords:
Coronary artery diseaseDiabetesDrug-eluting stentsPercutaneous coronary interventionTicagrelor

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