Adam C Salisbury1, James Sapontis2, J Aaron Grantham3, Mohammed Qintar3, Kensey L Gosch4, William Lombardi5, Dimitri Karmpaliotis6, Jeffrey Moses6, David J Cohen3, John A Spertus3, Mikhail Kosiborod3. 1. Saint Luke's Mid America Heart Institute, Kansas City, Missouri; University of Missouri-Kansas City, Kansas City, Missouri. Electronic address: asalisbury@saint-lukes.org. 2. Monash Heart, Melbourne, Australia. 3. Saint Luke's Mid America Heart Institute, Kansas City, Missouri; University of Missouri-Kansas City, Kansas City, Missouri. 4. Saint Luke's Mid America Heart Institute, Kansas City, Missouri. 5. University of Washington School of Medicine, Seattle, Washington. 6. Columbia University Medical Center, New York Presbyterian Hospital, New York, New York.
Abstract
OBJECTIVES: Few studies have evaluated the relationship of diabetes with technical success and periprocedural complications, and no studies have compared patient-reported health status after chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in patients with and without diabetes. BACKGROUND: CTOs are more common in patients with diabetes, yet CTO PCI is less often attempted in patients with diabetes than in patients without. The association between diabetes and health status after CTO PCI is unknown. METHODS: In the 12-center OPEN-CTO PCI registry (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Registry), patients with and without diabetes were assessed for technical success, periprocedural complications, and health status over 1 year following CTO PCI using the Seattle Angina Questionnaire and the Rose Dyspnea Scale. Hierarchical modified Poisson regression was used to examine the independent association between diabetes and technical success, and hierarchical multivariable linear regression was used to assess the association between diabetes and follow-up health status. RESULTS: Diabetes was common (41.2%) and associated with a lower crude rate of technical success (83.5% vs. 88.1%; p = 0.04). After adjustment, there was no significant difference between diabetic and nondiabetic patients (relative risk: 0.96, 95% confidence interval: 0.91 to 1.01). There were no significant differences in complication rates between patients with and without diabetes. Angina burden, quality of life, and overall health status scores were similar between diabetic and nondiabetic patients over 1 year. CONCLUSIONS: Although technical success was lower in patients with diabetes, this reflected lower success among patients with prior bypass surgery, without any significant difference in success rate after adjusting for prior bypass and disease complexity. CTO PCI complication rates are similar in diabetic and nondiabetic patients, and symptom improvement following CTO PCI is robust and of a similar magnitude regardless of diabetes status.
OBJECTIVES: Few studies have evaluated the relationship of diabetes with technical success and periprocedural complications, and no studies have compared patient-reported health status after chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in patients with and without diabetes. BACKGROUND: CTOs are more common in patients with diabetes, yet CTO PCI is less often attempted in patients with diabetes than in patients without. The association between diabetes and health status after CTO PCI is unknown. METHODS: In the 12-center OPEN-CTO PCI registry (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Registry), patients with and without diabetes were assessed for technical success, periprocedural complications, and health status over 1 year following CTO PCI using the Seattle Angina Questionnaire and the Rose Dyspnea Scale. Hierarchical modified Poisson regression was used to examine the independent association between diabetes and technical success, and hierarchical multivariable linear regression was used to assess the association between diabetes and follow-up health status. RESULTS:Diabetes was common (41.2%) and associated with a lower crude rate of technical success (83.5% vs. 88.1%; p = 0.04). After adjustment, there was no significant difference between diabetic and nondiabeticpatients (relative risk: 0.96, 95% confidence interval: 0.91 to 1.01). There were no significant differences in complication rates between patients with and without diabetes. Angina burden, quality of life, and overall health status scores were similar between diabetic and nondiabeticpatients over 1 year. CONCLUSIONS: Although technical success was lower in patients with diabetes, this reflected lower success among patients with prior bypass surgery, without any significant difference in success rate after adjusting for prior bypass and disease complexity. CTO PCI complication rates are similar in diabetic and nondiabeticpatients, and symptom improvement following CTO PCI is robust and of a similar magnitude regardless of diabetes status.
Authors: Marcelo Harada Ribeiro; Carlos M Campos; Lucio Padilla; Antonio Carlos B da Silva; João Eduardo T de Paula; Marco Alcantara; Ricardo Santiago; Franklin Hanna; Franciele R da Silva; Karlyse C Belli; Lorenzo Azzalini; Pedro P de Oliveira; Gustavo N Araujo; Vincenzo Sucato; Kambis Mashayekhi; Alfredo R Galassi; Alexandre Abizaid; Alexandre Quadros Journal: J Am Heart Assoc Date: 2022-06-03 Impact factor: 6.106
Authors: Neel M Butala; Hector Tamez; Eric A Secemsky; J Aaron Grantham; John A Spertus; David J Cohen; Philip Jones; Adam C Salisbury; Suzanne V Arnold; Frank Harrell; William Lombardi; Dimitrios Karmpaliotis; Jeffrey Moses; James Sapontis; Robert W Yeh Journal: J Am Heart Assoc Date: 2022-05-16 Impact factor: 6.106
Authors: Ali O Malik; John A Spertus; James A Grantham; Poghni Peri-Okonny; Kensey Gosch; James Sapontis; Jeffrey Moses; William Lombardi; Dimitri Karmpaliotis; William J Nicholson; Firas Al Badarin; Adam C Salisbury Journal: Am J Cardiol Date: 2020-01-08 Impact factor: 2.778