Comparison of clinical outcomes after drug-eluting stent implantation in diabetic versus nondiabetic patients in China

Abstract

Diabetes mellitus (DM) has been proved to be a predictor of adverse outcomes after percutaneous coronary intervention (PCI). Drug-eluting stents (DESs) could reduce the adverse events in DM patients. In this study, we aimed to analyze the clinical outcome after DES implantation in diabetic versus nondiabetic patients in China. Totally, 200 Chinese DM patients and 400 Chinese non-DM patients were enrolled in this retrospective study. Compared with non-DM patients, DM patients were more likely to have a higher incidence of cardiac death (3.5% vs. 1.0%, P = .048), stent thrombosis (2.5% vs. 0.5%, P = .044), target lesion revascularization (6.0% vs. 1.8%, P = .005), target vessel failure (15.5% vs. 8.0%, P < .001), target lesion failure (14.0% vs. 4.3%, P < .001), myocardial infarction (4.5% vs. 1.5%, P = .030), and major adverse cardiac events (12.5% vs. 5.0%, P = .001) at 2-year follow-up. However, the incidence of target vessel revascularization (7.5% vs. 5.5%, P = .340) was similar between DB and non-DB patients. Patients with DB (hazard ratio [HR] = 2.54, P = .001), older than 80 years (HR = 1.33, P = .027) with hypercholesterolemia (HR = 1.03, P < .001), serum creatinine >177 μmol/L (HR = 3.04, P = .011), a history of cerebral vascular accident (HR = 4.29, P = .010), or a history of myocardial infarction (HR = 31.4, P < .001) were more likely to experience adverse events. In China, DM could also be served as an independent predictor of adverse outcomes after DES implantation. These patients should be reexamined more frequently.

Percutaneous coronary intervention in insulin‐treated diabetic patients: A meta‐analysis

“…Compared with Bundhun's study, we only focused on RCTs and long‐term studies. Furthermore, we removed a retrospective cohort study (Beneduce et al, 2020 ) that was used as an RCT study by Hassen et al During the two‐year follow‐up, Jiang et al ( 2017 ) found that patients with ITDM were more susceptible to stent thrombosis, TVR, and MACCE. Jain et al ( 2010 ) showed that insulin therapy was not statistically correlated with the increased tendency of stent thrombosis, although ITDM is a high‐risk factor for other cardiovascular adverse events.…”

Long-term safety and efficacy of the Resolute stent: 5-year results from the RESOLUTE China Registry

“…The TLF rate for RESOLUTE Japan, included in the pooled analysis of Resolute studies, was also low with a rate of 5.6% at 4 years 13 . Reports of differences in thrombotic and thrombolytic status for Asian patients versus patients in Western countries have been postulated as reasons for differences in the underlying causes of thrombotic events 14,15 .…”

Impact of Diabetes Mellitus on Percutaneous Coronary Intervention Outcomes: Real-World Lessons From a Large Chinese Single-Center Registry

“…In a very recent retrospective study, Jiang et al presented data on apparent type 2 DM patients who were diagnosed by the following: an abnormal blood glucose level (≥126 mg/dL) after an overnight fast, an abnormal glycosylated hemoglobin test (≥6.5%), or an abnormal glucose tolerance test (2 hours, ≥200 mg/dL). 5 These patients type 2 DM were considered to have a disease predictive of adverse events after implantation of a DES. 5 In a meta-analysis by Zheng et al, it was found that increased blood levels of Hemoglobin A 1c were associated with increased major adverse cardiovascular events (MACEs) in patients with type 2 DM (these patients in the meta-analysis meet the criteria for type 2 DM as defined by the authors) following PCI.…”

“…5 These patients type 2 DM were considered to have a disease predictive of adverse events after implantation of a DES. 5 In a meta-analysis by Zheng et al, it was found that increased blood levels of Hemoglobin A 1c were associated with increased major adverse cardiovascular events (MACEs) in patients with type 2 DM (these patients in the meta-analysis meet the criteria for type 2 DM as defined by the authors) following PCI. 6 Wang et al report an analysis of the impact of type 2 DM (type 2 DM criteria met by age) on a large cohort of patients (n ¼10 724) who underwent PCI at a single high-volume center in China.…”