[Implantation of coronary stents in diabetic patients. Short- and medium-term clinical results].
Coronary balloon angioplasty is associated with a high incidence of restenosis in diabetics and of revascularisation of the culprit lesion and increased long-term mortality. The authors report the short and medium-term results of coronary stenting in diabetics. Between May 1995 and April 1997, 2,182 patients underwent coronary stenting. This population included 272 diabetics : 58 insulin-dependent and 214 non-insulin dependent (oral antidiabetics). Stents were implanted in vessels with mean diameters of 3 mm and over. During the hospital period, the complication rate (mortality, non-fatal myocardial infarction, emergency coronary bypass surgery, subacute thrombosis of the stent) was comparable in non-diabetics, insulin-dependent and non-insulin-dependent diabetics (2.55, 0 and 2.0% respectively). One patient (0.5%) died and another (0.5%) had non-fatal myocardial infarction (thrombosis of the stent) in the non-insulin-dependent group. No complications were observed in the insulin-dependent diabetic group. The mean clinical follow-up of 13 months (3-26 months) was respected in 93 and 97% of diabetics. The non-fatal myocardial infarction rate and revascularisation of the culprit lesion were comparable in the insulin and non-insulin-dependent groups (0 versus 0.5% and 8.2 versus 10.5% respectively) but global mortality was higher in the insulin-dependent diabetics (9.3 versus 2.4%).
Joseph
T
T
Service de cardiologie, hôpital Ambroise-Pare, Boulogne-Billancourt.
Fajadet
J
J
Laurent
J P
JP
Jordan
C
C
Cassagneau
B
B
Laborde
J C
JC
Marco
J
J
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002423:Cause of Death; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications; D012008:Recurrence; D019233:Retreatment; D015607:Stents / Q000009:adverse effects; D015996:Survival Rate