Outcome of diabetic and non-diabetic patients undergoing successful coronary angioplasty with bare stent of chronic total occlusion.
BACKGROUND
The prognosis of patients with diabetes mellitus and chronic coronary total occlusion (CTO) treated with percutaneous coronary angioplasty (PTCA) is poorly investigated.


METHODS
To compare the long-term outcome of patients with CTO, with and without diabetes mellitus and undergoing successful PTCA with bare stent implantation performed in a single centre, 170 consecutive patients (mean age 62 +/- 10 years) with CTO aged > 1 month were analysed. Death, myocardial infarction, repeat angioplasty and coronary artery by-pass were considered as hard events in 167 patients with available long-term follow-up (mean 25 +/- 15 months).


RESULTS
Vessel mean luminal diameter after the procedure and stent length were 2.5 +/- 0.4 mm and 21.9 +/- 9.4 mm, respectively. No differences were found in baseline clinical, angiographic and procedural variables between the groups, categorized on the basis of presence or absence of diabetes. There were 13 (27%) and 25 (21%) events in diabetic and non-diabetic groups, respectively (P = not significant). Multivariate analysis identified final mean luminal diameter (odds ratio = 4.7192, P = 0.0013) and stent length (odds ratio = 1.0655, P = 0.0003) but not diabetes (P = 0.78) as predictors of events at long-term follow-up.


CONCLUSIONS
Patients with and without diabetes undergoing CTO re-opening with stent implantation do not differ at long-term follow-up in terms of death, myocardial infarction and target lesion revascularizations. Final mean luminal diameter and stent length are significant predictors of events during long-term follow-up.
De Felice
Francesco
F
Unità Operativa Cardiologia Interventistica, Ospedale S. Camillo Forlanini, Roma, Italy. f.defelice@lycos.com
Fiorilli
Rosario
R
Parma
Antonio
A
Menichelli
Maurizio
M
Nazzaro
Marco Stefano
MS
Pucci
Edoardo
E
Musto
Carmine
C
Violini
Roberto
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D002908:Chronic Disease; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D048909:Diabetes Complications / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D019233:Retreatment; D015607:Stents; D016896:Treatment Outcome