[A comparison of the clinical and angiographic evolution of diabetic and nondiabetic patients treated by conventional angioplasty versus stent implantation in native coronary arteries].
OBJECTIVE
Diabetic patients have a high restenosis risk after balloon coronary angioplasty. Stent implantation in these patients appears to be a potential beneficial therapeutic option. The aim of this study was to compare the clinical and angiographic outcome of diabetic patients vs non-diabetic patients, treated with conventional angioplasty vs stent implantation in lesions located in native coronary arteries.


METHODS
A total of 302 patients (58 diabetics and 244 non-diabetics) underwent a coronary angioplasty of one vessel in native coronary arteries with initial success and after at least six months clinical and angiographic follow-up were included in the study. Of the total number of patients, 100 were treated with conventional balloon angioplasty and 202 with stent implantation. Major adverse clinical events and angiographic restenosis rate were evaluated at follow-up.


RESULTS
Mean age of patients was 65 years and 74% were male. Angiographic restenosis rate was similar in diabetic vs non-diabetic patients with stent implantation (24% vs 23% respectively). Nevertheless, diabetic patients treated with balloon angioplasty compared to diabetic patients treated with stenting, evolved with a higher restenosis rate (64% vs 24%; p < 0.05), and at the end of follow-up diabetics had need a higher rate of target vessel revascularization (40% vs 24%; p < 0.05), a lower major event free survival (56% vs 70%; p < 0.05) and worse symptomatic status (72% vs 36%; p < 0.05).


CONCLUSIONS
Diabetic patients treated with conventional one vessel coronary balloon angioplasty evolved with a high restenosis rate and a bad mid-term clinical outcome. Stent implantation was able reduce to the restenosis rate and improve the mid-term clinical outcome, in a comparable population of diabetic patients.
Navarro del Amo
L F
LF
Unidad de Hemodinámica y Cardiología Intervencionista, Fundación Jiménez Díaz, Madrid.
Iñiguez Romo
A
A
Ibargollín Hernández
R
R
García Belenguer
R
R
Fernández Rozas
I
I
Rodríguez Carreras
R C
RC
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D048909:Diabetes Complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015607:Stents / Q000009:adverse effects / Q000706:statistics & numerical data; D016896:Treatment Outcome