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Percutaneous coronary intervention for left main stem disease: Impact of diabetes mellitus on mortality

Bilal R Bawamia1, Mohaned Egred2,3, Matthew Jackson1

  • 1Cardiology Department, James Cook University Hospital, Middlesbrough, UK.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|March 6, 2020
PubMed

Insights

Diabetes mellitus (DM) did not significantly increase 30-day mortality after left main stem (LMS) percutaneous coronary intervention (PCI). However, insulin-treated diabetes (ITDM) was linked to increased long-term mortality in patients undergoing LMS PCI.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Limited real-world data exists on outcomes for diabetic patients undergoing left main stem (LMS) percutaneous coronary intervention (PCI).
  • Understanding the impact of diabetes mellitus (DM) on mortality after LMS PCI is crucial for patient management.

Purpose of the Study:

  • To assess the impact of DM on mortality following LMS PCI.
  • To compare mortality outcomes between non-insulin-treated DM (NITDM) and insulin-treated DM (ITDM) in various clinical settings.

Main Methods:

  • Retrospective analysis of 2,675 patients undergoing unprotected LMS PCI at two high-volume tertiary centers (2003-2017).
  • Data collected on diabetic status, clinical setting, and all-cause mortality at 30 days and up to 36 months post-PCI.

Main Results:

  • DM was not associated with increased 30-day mortality (OR 1.39, p = .15).
  • A borderline association was found between DM and long-term mortality (HR 1.31, p = .05).
  • Insulin-treated DM (ITDM), but not NITDM, was significantly associated with both short- and long-term mortality.

Conclusions:

  • DM generally does not impact 30-day mortality after LMS PCI.
  • Long-term mortality shows a borderline association with DM, primarily driven by insulin-treated patients.
  • The significant impact of DM on mortality outcomes post-LMS PCI is confined to insulin-treated individuals.
Abstract

Keywords:
diabetes mellitusleft Main Coronary Diseasepercutaneous Coronary Intervention

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