Impact of diabetes mellitus on outcome of patients undergoing carotid artery stenting: insights from a single center registry.
OBJECTIVE
To evaluate the impact of diabetic status on outcome of patients undergoing carotid artery stenting (CAS).


BACKGROUND
Diabetes has been demonstrated to be a strong predictor of adverse outcome in patients undergoing coronary revascularization. Its significance in predicting outcome of patients undergoing carotid interventions has not been ascertained.


METHODS
We evaluated the short-term outcomes of 833 patients who underwent CAS at our institution. The primary outcome of this analysis was 30 day incidence of stroke, myocardial infarction, and death.


RESULTS
Diabetes was present in 311 patients. Baseline characteristics were comparable between diabetics and nondiabetics except for the diabetics having a lower left ventricular ejection fraction, lower hemoglobin, and a higher body mass index at baseline. Further, they were more likely to have congestive heart failure and coronary artery disease. There was no difference in the incidence of stroke (1.9% versus 2.7%,), myocardial infarction (MI) (2.6% versus 1.9%), death (3.9% versus 2.5%), or the composite of death stroke or MI (6.8% versus 5.9%) at 30 days between diabetics and nondiabetics. Similar results were seen when the analysis was restricted to patients treated with an emboli protection device. Diabetes was not a risk factor for adverse outcome after CAS after multivariate adjustment.


CONCLUSIONS
Diabetics undergoing CAS are more likely to have associated co-morbidities. However despite this handicap, their short term outcome after CAS is similar to that of nondiabetics.
Gurm
Hitinder S
HS
Cleveland Clinic Foundation, Cleveland, OH, USA. hgurm@med.umich.edu
Rajagopal
Vivek
V
Sachar
Ravish
R
Abou-Chebl
Alex
A
Kapadia
Samir R
SR
Bajzer
Chris
C
Yadav
Jay S
JS
D000368:Aged; D000369:Aged, 80 and over; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000401:mortality; D002340:Carotid Artery Diseases / Q000601:surgery*; D017536:Carotid Artery, Common / Q000601:surgery*; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D009820:Ohio; D011237:Predictive Value of Tests; D012042:Registries; D012044:Regression Analysis; D012107:Research Design; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome