[Impact of diabetes mellitus on the late clinical outcome of coronary revascularization with stents].
BACKGROUND
The Influence of diabetes mellitus in the late outcome of coronary stenting remains controversial.


OBJECTIVE
The aim of this study was to determine the late clinical outcome of diabetics in comparison with non diabetics and to establish whether there are subgroups of diabetic patients with a greater need for target lesion revascularization.


METHODS
Two hundred sixteen consecutive patients (74 diabetics; 95 stents in 90 lesions and 142 non diabetics) who had successfully undergone coronary stenting were included in the study and followed over 17.6 +/- 10 months. The clinical events evaluated were target lesion revascularization, death and acute myocardial infarction. Independent predictive variables of target lesion revascularization were studied in both groups of patients.


RESULTS
The diabetic patients presented greater cardiovascular mortality (6.7% vs 1.4%; p=0.02) but the incidence of infarction was similar in the two groups (2.7% vs. 3.5%; p=0.6). The accumulated rate of target lesion revascularization at two years was 18.2% in diabetics vs 13.3% in non diabetics (p=0.09), respectively. The presence of three vessel disease (p=0.014), history of arterial hypertension ([=0.011) and residual stenosis > 0% (p=0.005) were specific predictive factors of target lesion revascularization for diabetic patients and together with vessel diameter < 3mm (p<0.001) subgroups of diabetics were independently selected with a significantly greater incidence of target lesion revascularization than the non diabetic patients.


CONCLUSIONS
Following coronary stenting, diabetic patients show a greater cardiovascular mortality than non diabetics, but only some subgroups of diabetics (small vessels extensive coronary disease, associated arterial hypertension, residual stenosis) show a significantly greater risk of target lesion revascularization.
Pascual Figal
D A
DA
Servicio de Cardiología. Hospital Universitario Virgen de la Arrixaca. Murcia.
Valdés Chávarri
M
M
García Almagro
F
F
Garzón Rodríguez
A
A
González Carrillo
J
J
García Alberola
A
A
Soria Arcos
F
F
D003327:Coronary Disease / Q000150:complications* / Q000601:surgery*; D048909:Diabetes Complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D012307:Risk Factors; D015607:Stents; D013997:Time Factors