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Impact of Diabetes Mellitus on Outcomes after High-Risk Interventional Coronary Procedures

Laura Johannsen1, Julian Soldat1, Andrea Krueger1

  • 1Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Hospital Essen, Medical Faculty, 45147 Essen, Germany.

Journal of Clinical Medicine
|October 29, 2020
PubMed

Insights

Diabetes mellitus (DM) did not significantly increase in-hospital adverse events or reduce one-year survival in high-risk patients undergoing percutaneous coronary intervention (PCI). These findings suggest PCI is a viable option for high-risk patients with DM.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Diabetology

Background:

  • High-risk patients with coronary artery disease often face increased operative risks with traditional surgery.
  • Percutaneous coronary intervention (PCI) is an alternative for patients unsuitable for coronary artery bypass grafting (CABG).
  • The impact of diabetes mellitus (DM) on outcomes after high-risk PCI requires further investigation.

Purpose of the Study:

  • To evaluate the outcomes of patients with DM undergoing high-risk PCI.
  • To compare in-hospital major adverse cardiac and cerebrovascular events (MACCEs) and one-year survival between diabetic and non-diabetic patients.

Main Methods:

  • Retrospective analysis of consecutive high-risk PCI patients from January 2016 to August 2018.
  • Assessment of in-hospital MACCEs (stroke, myocardial infarction, death) and one-year all-cause mortality.
  • Comparison of outcomes between patients with and without DM.

Main Results:

  • A total of 276 patients underwent high-risk PCI; 31% had DM.
  • In-hospital MACCEs occurred in 6% of DM patients versus 2% of non-DM patients (p=0.24).
  • One-year survival rates were 87.1% for DM patients and 93.6% for non-DM patients (p=0.07), with no significant difference based on coronary complexity.

Conclusions:

  • In selected high-risk patients, DM was not associated with significantly increased in-hospital MACCEs after high-risk PCI.
  • One-year survival rates were comparable between diabetic and non-diabetic patients undergoing high-risk PCI.
  • High-risk PCI appears to be a safe and effective revascularization strategy for patients with DM and complex coronary artery disease.

Keywords:
Impelladiabetes mellitushigh-risk percutaneous coronary interventionmechanical circulatory support

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