Diabetes e implante de stents coronarianos: experiência de um centro de referência em cardiologia intervencionista

Abstract

We evaluated the influence of diabetes mellitus (DM) on clinical outcomes in patients with coronary artery disease treated with stent implantation. Between 1996 and 2000, 934 stents were implanted in 893 patients in our institution; 23% of them had DM. Clinical and angiographic characteristics and clinical outcomes of the patients with and without DM were prospectively included in a computerized database. Diabetics were older (61.5 +/- 10 vs. 59.8 +/- 11 years; p = 0.04) and had a higher prevalence of hypertension (69% vs. 62%; p = 0.09). The procedural clinical success rate (successful coronary stenting with residual stenosis < 30%, TIMI 3 flow and no in-hospital adverse clinical event) was lower in the diabetic group (88% vs. 92%; p = 0.05). In the 1-year follow up, diabetic patients showed higher rates of new target vessel revascularization (12.3% vs. 8%; p = 0.06), death (5.4% vs. 2.5%; p = 0.03) and major adverse cardiovascular events (MACE, new angioplasty, surgery, acute myocardial infarction or death: 16.3% vs. 9.3%; p = 0.003). Diabetes was independently associated to 1-year MACE on multivariate analysis (OR: 2.00; IC: 1.25-3.24; = 0.004). We concluded that DM is associated with higher complication and restenosis rates and a higher risk of long-term major cardiovascular events in patients treated with coronary stent implantation.

Estudo dos custos das internações por cardiopatia isquêmica em indivíduos com e sem diabetes mellitus em centro de referência cardiológico do Sistema Único de Saúde brasileiro

“…Eles observaram uma maior frequência de hipertensão arterial sistêmica no grupo de pacientes com DM (p = 0,09) e menor frequência de tabagismo (p = 0,09), além de maior prevalência de dislipidemia (p = 0,04). Não houve diferença estatisticamente significante em relação ao IAM (p =0,22) (Schaan et al, 2006).…”