OBJECTIVE: Diabetic patients are known to have reduced long-term survival following percutaneous transluminal coronary angioplasty compared with nondiabetic patients. However, it is unknown whether this survival disadvantage has persisted in the era of contemporary percutaneous coronary intervention (PCI) techniques, which include the widespread use of stents and the availability of platelet glycoprotein (GP) IIb/IIIa inhibitors. RESEARCH DESIGN AND METHODS: Three hospitals in New York City contributed prospectively defined data on 4,284 patients undergoing PCI. The primary end point was all-cause mortality following hospital discharge for PCI. RESULTS: Hypertension, renal insufficiency, and renal failure requiring dialysis were all more common in diabetic patients, whereas active smoking was less frequent. Congestive heart failure on admission was more common in diabetic than nondiabetic patients (7.7 vs. 4.0%, P < 0.001). Stents were placed in 78% of nondiabetic patients and 75% of diabetic patients (P = 0.045). Platelet GP IIb/IIIa antagonists were administered to 23% of nondiabetic and 24% of diabetic patients (P = NS). At a mean follow-up of 3 years, mortality was 8% among nondiabetic patients and 13% for diabetic patients (P < 0.001). After adjustment for differences in baseline characteristics between nondiabetic and diabetic patients, diabetes remained a significant independent hazard for late mortality (hazard ratio 1.462, 95% CI 1.169-1.828; P = 0.001). CONCLUSIONS: Following contemporary PCI, diabetic patients continue to have worse survival than nondiabetic patients.
OBJECTIVE:Diabeticpatients are known to have reduced long-term survival following percutaneous transluminal coronary angioplasty compared with nondiabetic patients. However, it is unknown whether this survival disadvantage has persisted in the era of contemporary percutaneous coronary intervention (PCI) techniques, which include the widespread use of stents and the availability of platelet glycoprotein (GP) IIb/IIIa inhibitors. RESEARCH DESIGN AND METHODS: Three hospitals in New York City contributed prospectively defined data on 4,284 patients undergoing PCI. The primary end point was all-cause mortality following hospital discharge for PCI. RESULTS:Hypertension, renal insufficiency, and renal failure requiring dialysis were all more common in diabeticpatients, whereas active smoking was less frequent. Congestive heart failure on admission was more common in diabetic than nondiabeticpatients (7.7 vs. 4.0%, P < 0.001). Stents were placed in 78% of nondiabetic patients and 75% of diabeticpatients (P = 0.045). Platelet GP IIb/IIIa antagonists were administered to 23% of nondiabetic and 24% of diabeticpatients (P = NS). At a mean follow-up of 3 years, mortality was 8% among nondiabetic patients and 13% for diabeticpatients (P < 0.001). After adjustment for differences in baseline characteristics between nondiabetic and diabeticpatients, diabetes remained a significant independent hazard for late mortality (hazard ratio 1.462, 95% CI 1.169-1.828; P = 0.001). CONCLUSIONS: Following contemporary PCI, diabeticpatients continue to have worse survival than nondiabetic patients.
Authors: Geanina Onuta; Hendrik C Groenewegen; Flip A Klatter; Mark Walther Boer; Maaike Goris; Harry van Goor; Anton J M Roks; Jan Rozing; Bart J G L de Smet; Jan-Luuk Hillebrands Journal: J Biomed Biotechnol Date: 2011-02-09
Authors: Sripal Bangalore; Sunil Kumar; Mario Fusaro; Nicholas Amoroso; Ajay J Kirtane; Robert A Byrne; David O Williams; James Slater; Donald E Cutlip; Frederick Feit Journal: BMJ Date: 2012-08-10