title: Comparison between diabetic and non-diabetic patients after successful percutaneous coronary intervention for chronic total occlusions in the drug-eluting stent era.
abstract: OBJECTIVE
  Diabetes mellitus and chronic total occlusions are associated with unfavorable outcome after percutaneous coronary intervention. We sought to assess the clinical and angiographic outcomes of diabetic and non-diabetic patients who underwent successful percutaneous revascularization of chronic total occlusions with drug-eluting stents.
  
  
  METHODS
  Baseline clinical and angiographic characteristics, procedural details, nine-month angiographic follow-up and clinical events at 12 months were compared between 75 diabetic and 132 non-diabetic patients included in a clinical trial that randomized successful recanalization of chronic total occlusions to receive sirolimus- or everolimus-eluting stents.
  
  
  RESULTS
  In both diabetic and non-diabetic groups there was a favorable non-significantly different angiographic result at nine months, with low in-stent late loss (0.14±0.60 mm vs. 0.25±0.68 mm, p=0.305) and rates of binary restenosis (4.0% vs. 10.6%, p=0.180) and reocclusion (0.0% vs. 2.3%, p=0.334). During follow-up similar survival from death (97.3±1.9% vs. 99.2±0.8%, log-rank p=0.273), acute myocardial infarction (100.0±0.0% vs. 97.7±1.3%, log-rank p=0.192), target vessel revascularization (88.7±3.8% vs. 88.2±2.9%, log-rank p=0.899) and stent thrombosis (100.0±0.0% vs. 97.7±1.3%, log-rank p=0.192) was observed. Furthermore, the presence of more diffuse peripheral and coronary artery disease and higher frequency of calcified lesions in diabetic patients did not lead to significant differences in the approach (20.0% vs. 25.0% radial approach, p=0.413), strategy (6.7% vs. 3.8% retrograde strategy, p=0.353), total stent length (48.1±24.6 mm vs. 49.2±23.9 mm, p=0758) or contrast volume (261.3±116.4 ml vs. 297.4±135.9 ml, p=0.109) required for revascularization.
  
  
  CONCLUSIONS
  In the drug-eluting stent era, diabetic and non-diabetic patients have comparable favorable clinical and angiographic outcomes after successful percutaneous revascularization of chronic total occlusions.
authors.affiliation: Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain; Servicio de Cardiología, Hospital Universitario Quiron, Madrid, Spain; Servicio de Cardiología, Hospital Universitario de Torrejón, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Ruiz-Garcia
authors.affiliation: Servicio de Cardiología, Hospital de Santa Cruz, Lisboa, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Teles
authors.affiliation: Servicio de Cardiología, Hospital de Galdakao, Bilbao, Spain.
authors.forename: José-Ramón
authors.initials: JR
authors.lastname: Rumoroso
authors.affiliation: Servicio de Cardiología, Hospital de Santo Antonio, Porto, Portugal.
authors.forename: Henrique
authors.initials: H
authors.lastname: Cyrne Carvalho
authors.affiliation: Servicio de Cardiología, Hospital Puerta de Hierro, Majadahonda, Spain.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Goicolea
authors.affiliation: Servicio de Cardiología, Hospital Virgen de la Salud, Toledo, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Moreu
authors.affiliation: Servicio de Cardiología, Hospital German Trias i Pujol, Badalona, Spain.
authors.forename: Josefa
authors.initials: J
authors.lastname: Mauri
authors.affiliation: Servicio de Cardiología, Hospital General, Alicante, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Mainar
authors.affiliation: Servicio de Cardiología, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Eulogio
authors.initials: E
authors.lastname: García
authors.affiliation: Sección de Hemodinámica y Cardiología Intervencionista, Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain. Electronic address: raulmorenog@hotmail.com.
authors.forename: Raul
authors.initials: R
authors.lastname: Moreno
mesh_terms: D002908:Chronic Disease; D003131:Combined Modality Therapy; D054059:Coronary Occlusion / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention
keywords: Chronic total occlusion; Diabetes; Drug-eluting stent; Intervenção coronária percutânea; Oclusão crónica total; Percutaneous coronary intervention; Stent revestido