title: Long-term outcomes after percutaneous coronary intervention in patients with and without diabetes mellitus in Western Denmark.
abstract: Patients with diabetes mellitus have worse outcomes after percutaneous coronary intervention than patients without diabetes mellitus. We compared the risk of stent thrombosis, myocardial infarction, death, and target lesion revascularization in diabetic and nondiabetic patients after implantation of drug-eluting stents or bare metal stents. In the Western Denmark Heart Registry, 12,347 consecutive patients (1,575 with and 10,772 without diabetes) were identified and followed up for 2 years. The 2-year risk of definite stent thrombosis was 0.52% in patients with diabetes mellitus and 0.71% in nondiabetic patients (adjusted relative risk [RR] 0.74, 95% confidence interval [CI] 0.41 to 1.34, p = 0.321). The 2-year risk of myocardial infarction was greater in the diabetic patients (6.9%) than in the nondiabetic patients (3.6%; adjusted RR 1.96, 95% CI 1.58 to 2.43; p <0.001). The all-cause 2-year mortality rate was almost twice as great for the diabetic patients compared to the nondiabetic patients (12.4% vs 6.7%; adjusted RR 1.91, 95% CI 1.63 to 2.23; p <0.001). The 2-year risk of target lesion revascularization was 8.5% in the diabetic patients and 6.8% in the nondiabetic patients (adjusted RR 1.28, 95% CI 1.10 to 1.49; p <0.001). In conclusion, 2 years after drug-eluting stent or bare metal stent implantation, diabetic patients had a greater risk than nondiabetic patients of myocardial infarction and death. Drug-eluting stent treatment reduced the risk of target lesion revascularization compared to bare metal stent treatment, regardless of diabetes status.
authors.affiliation: Department of Cardiology, Odense University Hospital, Odense, Denmark. okkels@dadlnet.dk
authors.forename: Lisette Okkels
authors.initials: LO
authors.lastname: Jensen
authors.forename: Michael
authors.initials: M
authors.lastname: Maeng
authors.forename: Per
authors.initials: P
authors.lastname: Thayssen
authors.forename: Anne
authors.initials: A
authors.lastname: Kaltoft
authors.forename: Hans Henrik
authors.initials: HH
authors.lastname: Tilsted
authors.forename: Jens Flensted
authors.initials: JF
authors.lastname: Lassen
authors.forename: Knud Noerregaard
authors.initials: KN
authors.lastname: Hansen
authors.forename: Morten
authors.initials: M
authors.lastname: Bottcher
authors.forename: Klaus
authors.initials: K
authors.lastname: Rasmussen
authors.forename: Morten
authors.initials: M
authors.lastname: Madsen
authors.forename: Søren Paaske
authors.initials: SP
authors.lastname: Johnsen
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sørensen
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003328:Coronary Thrombosis / Q000209:etiology / Q000401:mortality; D003718:Denmark / Q000453:epidemiology; D048909:Diabetes Complications / Q000401:mortality* / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome