[Influence of diabetes mellitus on the initial and long-term outcome of patients treated with coronary stenting].
OBJECTIVE
The long-term outcome of patients with diabetes who underwent stent placement has not been assessed comprehensively.


METHODS
Analysis of angioplasty procedures performed between January 1994 and December 1998 identified 140 diabetics (156 lesions) and 169 non-diabetics (187 lesions) who underwent successful stent placement. Follow-up was completed in 286 patients (93%) with a mean follow-up period of 2.8 +/- 1.3 years. Cardiac death, nonfatal myocardial infarction, coronary artery bypass grafting and repeat percutaneous transluminal coronary angioplasty were considered as adverse cardiac events. The primary clinical endpoint was event-free survival at 1 and 3 years. The primary angiographic endpoint was restenosis rate at follow-up angiography (follow-up rate 75% of 257 lesions).


RESULTS
The diabetics were older (66 +/- 8 vs 62 +/- 11 years, p < 0.0005) with more risk factors such as hypertension (69% vs 57%, p < 0.05) and multivessel disease (69% vs 51%, p < 0.005). Final balloon size was smaller in diabetics than in non-diabetics (3.26 +/- 0.61 vs 3.39 +/- 0.53 mm, p < 0.05). Restenosis rate was significantly higher in diabetics than in non-diabetics (36% vs 24%, p < 0.05), but the target lesion revascularization in diabetics was not statistically different compared with non-diabetics (22% vs 16%). Long-term event-free survival was not significantly different between diabetics and non-diabetics (69.9% vs 74.8% at 1 year, 57.3% vs 66.0% at 3 years).


CONCLUSIONS
Diabetics have an increased risk for angiographical restenosis after successful stent placement compared to non-diabetics. However, diabetics who underwent stent placement had a favorable clinical long-term outcome similar to non-diabetics.
Tanigawa
Takashi
T
Division of Cardiology, Cardiovascular Center, Toranomon Hospital, Toranomon 2-2-2, Minato-ku, Tokyo 105-8470.
Ishiwata
Sugao
S
Yamamoto
Takanobu
T
Fujimoto
Yoh
Y
Nameki
Mizuo
M
Koizumi
Tomomi
T
Iwase
Takashi
T
Nishiyama
Shin-ichiro
S
Nakanishi
Shigemoto
S
Momomura
Shin-ichi
S
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000628:therapy*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D015607:Stents / Q000706:statistics & numerical data; D016896:Treatment Outcome