title: Impact of diabetes mellitus status on coronary pathoanatomy and interventional treatment: insights from the Euro heart survey PCI registry.
abstract: OBJECTIVE
  The present analysis was performed to evaluate the impact of diabetes mellitus (DM) status on the severity of coronary artery disease (CAD) and current approaches in interventional treatment.
  
  
  BACKGROUND
  Little is known about the effect of DM treated with diet, oral agents, or insulin on lesion characteristics and anatomical pattern of CAD and their interventional treatment.
  
  
  RESULTS
  Patients (n = 46,779) of the contemporary Euro Heart Survey PCI registry with known DM status were included in this analysis. Nondiabetics (n = 35,280, 75.4%) were compared with diabetics treated with diet (n = 1,533, 3.3%), oral agents (n = 7,222, 15.4%), and insulin (n = 2,744, 5.8%). Diabetic patients were older, suffered more frequently from comorbidities and presented more often with cardiogenic shock. The number of severely stenosed (≥ 70%) segments incrementally increased from nondiabetics to insulin-requiring diabetics. The location of lesions did not differ between patients with and without DM. The ratio stenosed/treated segments progressively rose among the four patient cohorts. The severity of DM negatively correlated with the extent of complete revascularization. After adjustment for confounding variables no significant differences in hospital mortality could be observed between patients without DM and diabetics treated with diet, but a significantly higher rate of death was seen in diabetic patients with oral medication and insulin therapy.
  
  
  CONCLUSIONS
  Although CAD was more severe in patients with DM the percentage of treated segments with ≥ 70% stenosis was lower. Adjusted hospital mortality was increased among diabetics treated with oral medication or insulin, but not among those treated with diet.
authors.affiliation: Kerckhoff Heart Center, Bad Nauheim, Germany. Bauer-Timm@gmx.de.
authors.forename: Timm
authors.initials: T
authors.lastname: Bauer
authors.forename: Helge
authors.initials: H
authors.lastname: Möllmann
authors.forename: Franz
authors.initials: F
authors.lastname: Weidinger
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.forename: Ricardo
authors.initials: R
authors.lastname: Seabra-Gomes
authors.forename: Franz
authors.initials: F
authors.lastname: Eberli
authors.forename: Patrick
authors.initials: P
authors.lastname: Serruys
authors.forename: Alec
authors.initials: A
authors.lastname: Vahanian
authors.forename: Sigmund
authors.initials: S
authors.lastname: Silber
authors.forename: William
authors.initials: W
authors.lastname: Wijns
authors.forename: Matthias
authors.initials: M
authors.lastname: Hochadel
authors.forename: Holger M
authors.initials: HM
authors.lastname: Nef
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hamm
authors.forename: Jean
authors.initials: J
authors.lastname: Marco
authors.forename: Anselm K
authors.initials: AK
authors.lastname: Gitt
mesh_terms: D000284:Administration, Oral; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003920:Diabetes Mellitus / Q000178:diet therapy / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007267:Injections; D007328:Insulin / Q000008:administration & dosage*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D007004:Hypoglycemic Agents; D007328:Insulin