Diabetes mellitus and unstable coronary artery disease: Improved clinical outcome of coronary artery stenting in an era of glycoprotein IIb/IIIa inhibitors and lipid-lowering therapy

Vassilis A. Voudris, John S. Skoularigis, Yvonne K. Dimitriou, Georgia N. Grapsa, John S. Malakos, Gregory S. Pavlides, Athanasios N. Manginas, Dennis V. Cokkinos

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The short- and long-term clinical outcomes of coronary artery stenting in diabetic patients with unstable coronary artery disease were assessed and compared with a cohort of non-diabetic patients in the context of platelet glycoprotein IIb/IIIa inhibitors and lipid-lowering therapy. Methods: The study population comprised 252 consecutive patients with unstable angina who underwent coronary artery stenting; of these 46 were diabetic and 206 were non-diabetic. In-hospital results and clinical outcome during follow-up (24 ± 13 months, range 7-56 months) were obtained in all patients without major in-hospital complications. Survival curves and multivariate models for any late clinical event were reported. Results: A high clinical success rate and no difference in in-hospital complications between the two groups of patients were observed. Complete revascularization rate was similar in diabetic and non-diabetic patients (48% compared with 52%). A greater proportion of diabetic than non-diabetic patients received IIb/IIIa inhibitors during the procedure and lipid-lowering drugs at hospital discharge (87% compared with 46%, P=0.001 and 83% compared with 61%, P=0.006 respectively). At 2-year clinical follow-up, the incidences of death and myocardial infarction were similar in both groups; the need for any revascularization was only slightly higher in diabetic patients (P=NS). Incomplete revascularization and multi-vessel disease were independent predictors of any revascularization. Conclusions: Coronary artery stenting combined with glycoprotein IIb/IIIa inhibitor infusion and long-term lipid-lowering therapy is an effective therapeutic strategy in diabetic patients with unstable coronary artery disease and is associated with good short- and long-term results, comparable to those observed in non-diabetic patients.

Original languageEnglish (US)
Pages (from-to)353-359
Number of pages7
JournalCoronary Artery Disease
Volume15
Issue number6
DOIs
StatePublished - Sep 2004

Keywords

  • Coronary stenting
  • Diabetes
  • Glycoprotein IIb/IIIa inhibitors
  • Lipid-lowering therapy
  • Unstable coronary artery disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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