Repeat adverse events long after percutaneous coronary revascularization in diabetics.
OBJECTIVE
Diabetics with coronary artery disease face a high risk of adverse events following coronary revascularization. However, recurrence rates of after the first revascularization have never been appraised. The aim of this study was to evaluate recurrent events in diabetics undergoing percutaneous coronary intervention (PCI) in the current era.


METHODS
Authors collected baseline and outcome data of consecutive type-2 diabetics treated with PCI (July 2002-December 2005) . End-points of interest were the long-term rates of major adverse cardiac events (MACE: cardiac death, myocardial infarction [MI], percutaneous target vessel revascularization [TVR-PCI], or coronary artery bypass grafting [CABG]), non-TVR PCI, and stent thrombosis.


RESULTS
A total of 429 diabetics were included, 191 (44%) insulin-dependent, with drug-eluting stents implanted in 232 (54%). After a median of 38 months, events were as follows: MACE in 167 (38.9%) subjects, cardiac death in 38 (8.8%), MI in 42 (9.8%), TVR-PCI in 130 (30.3%), CABG in 11 (2.6%), non-TVR-PCI in 52 (12.1%), and definite stent thrombosis in 9 (2.1%). Among the 129 patients undergoing TVR-PCI as first event, as many as 28 (21.7%) underwent a second TVR-PCI, 7 (5.4%) underwent a third TVR-PCI, and a further 2 (1.5%) underwent a fourth TVR-PCI, whereas CABG was performed in 2 (1.5%) and non-TVR-PCI in 4 (3.1%).


CONCLUSIONS
This work, originally reporting on the risk of recurrent repeat revascularization events among diabetics treated with PCI, showed that adverse events occur frequently in these patients, but can be managed in most cases safely and successfully by means of repeat PCI only.
Division of Cardiology, University of Turin, Turin, Italy.
E
E
Cavallero
G
G
Biondi-Zoccai
A
A
Mazzanti
C
C
Moretti
F
F
Sciuto
P
P
Omedé
R
R
Siliquini
S
S
Chiadò
G P
GP
Trevi
I
I
Sheiban
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D013997:Time Factors