Long-term results after drug-eluting stent implantation in diabetic patients according to diabetic treatment

Vassilis Voudris, Panagiotis Karyofillis, Sofia Thomopoulou, Constantinos Doulaptsis, Athanasios Manginas, Gregory Pavlides, Dennis V. Cokkinos

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Introduction: In this prospective, single-center study we assessed the long-term results after drug-eluting stent implantation in non insulin-dependent diabetic patients compared to insulin-dependent patients. Methods: A total of 610 consecutive diabetic patients (mean age 65 ± 9 years) underwent percutaneous coronary intervention with drug-eluting stent implantation. They were classified into 2 groups according to their diabetic treatment: 1) non insulin-dependent patients (477); 2) insulin-dependent patients (133). The primary endpoint was the composite of death, non-fatal myocardial infarction, bypass surgery and target lesion revascularization. Results: Clinical follow up for more than 12 months (median 29 months) was achieved in 597/610 patients (98%). The insulin-dependent group had more women (29% vs. 18%, p=0.003), as well as a higher incidence of multivessel disease (84% vs. 65%, p<0.0001) and ejection fraction <40% (16% vs. 9%, p=0.037) compared to the non insulin-dependent group. The in-hospital results were almost the same in both groups, except for the incidence of non-Q myocardial infarction and bleeding complications, which were more frequent in the insulin-dependent group (9.8% vs. 4.8%, p=0.03, and 1.5% vs. 0%, p=0.047, respectively). During clinical follow up, no significant differences in the incidence of death or non-fatal myocardial infarction were observed, but target lesion revascularization and bypass surgery were more frequent in the insulin-dependent group (8.5% vs. 3.4%, p=0.01, and 4.7% vs. 1.3%, p=0.01, respectively). The event-free survival was lower in the insulin-dependent group (hazard ratio: 0.52; 95% confidence interval, 0.31-0.85, p=0.01). Conclusion: The implantation of drug-eluting stents in diabetics is associated with excellent in-hospital and long-term results. However, the long-term effectiveness in insulin-dependent patients is lower, because of the greater risk of new revascularization.

Original languageEnglish (US)
Pages (from-to)15-22
Number of pages8
JournalHellenic Journal of Cardiology
Volume52
Issue number1
StatePublished - Jan 1 2011

Keywords

  • Angioplasty
  • Coronary artery disease
  • Diabetes mellitus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Long-term results after drug-eluting stent implantation in diabetic patients according to diabetic treatment'. Together they form a unique fingerprint.

  • Cite this

    Voudris, V., Karyofillis, P., Thomopoulou, S., Doulaptsis, C., Manginas, A., Pavlides, G., & Cokkinos, D. V. (2011). Long-term results after drug-eluting stent implantation in diabetic patients according to diabetic treatment. Hellenic Journal of Cardiology, 52(1), 15-22.