title: Clinical Outcomes in Diabetic Patients Who Underwent Percutaneous Coronary Intervention during the Plain Old Balloon Angioplasty (POBA)-, Bare Metal Stents (BMS)- and Drug-eluting Stents (DES)-eras from 1984 to 2010.
abstract: Objective Diabetes is a negative predictor in coronary artery disease patients. Since the introduction of percutaneous coronary intervention (PCI), PCI has evolved through technological advances in devices, improvements in operators' techniques and the establishment of effective therapeutic protocols. The aim of this study is to examine the changes in the clinical outcomes following PCI in patients with diabetes. Methods We compared the clinical outcomes in patients with diabetes following PCI from 1984 to 2010 at Juntendo University over three eras (plain old balloon angioplasty (POBA)-, bare metal stents (BMS)- and drug-eluting stents (DES)-eras). The primary endpoint was a composite of all-cause mortality, non-fatal myocardial infarction, non-fatal stroke and repeat revascularization within 3 years after the index PCI. Results A total of 1,584 patients were examined. The baseline characteristics became unfavorable over time with regard to age, prevalence of hypertension, presentation with acute coronary syndrome and a reduced left ventricular ejection fraction. The administration of aspirin, statins and -blockers increased over time. The event-free survival rate for the 3-year cardiovascular events was lower in the DES-era. The adjusted relative risk reduction for 3-year cardiovascular events was 46 % in the DES-era compared with the POBA-era. Conclusion The incidence of 3-year cardiovascular events decreased from 1984 to 2010 in patients with diabetes following PCI, despite the higher risk profiles in the DES-era.
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Naito
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Konishi
authors.forename: Shuta
authors.initials: S
authors.lastname: Tsuboi
authors.forename: Manabu
authors.initials: M
authors.lastname: Ogita
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tamura
authors.forename: Shinya
authors.initials: S
authors.lastname: Okazaki
authors.forename: Kikuo
authors.initials: K
authors.lastname: Isoda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000401:mortality; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000401:mortality*; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D000069322:Self Expandable Metallic Stents / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome