Success rates of percutaneous coronary intervention of chronic total occlusions and long-term survival in patients with diabetes mellitus

Diab Vasc Dis Res. 2006 May;3(1):45-51. doi: 10.3132/dvdr.2006.006.

Abstract

The objectives of this study were to evaluate angiographic and clinical outcomes among patients with diabetes mellitus (DM) who underwent percutaneous coronary intervention (PCI) for a chronic total occlusion (CTO). We compared them with matched patients undergoing PCI of a non-CTO lesion. All patients had documented DM. Matching was performed using a propensity score for CTO. There were 506 patients with DM and CTO who were matched with a non-CTO group. Results showed that angiographic success rates were lower with CTO (75% vs. 93%, p<0.001). In-hospital major adverse cardiac event (MACE - death, urgent bypass surgery, Q-wave myocardial infarction or target vessel revascularisation) rates were equivalent (CTO 3.2% vs. non-CTO 2.6%, p=0.57). Survival was not different five years after revascularisation of CTO (75%) vs. non-CTO (79%) (p=0.20). In addition, when DM patients with CTO were analysed according to angiographic success of PCI, there were no significant differences in either in-hospital (success 1.6% vs. failure 2.4%, p=0.7) or 1-year mortality (success 22.2% vs. failure 26.8%, p=0.3). We conclude that PCI of CTO is safe in patients with DM. Angiographic failure is not associated with an increase in MACE rates or mortality as compared to matched non-CTO patients. However, there is not a measurable improvement in survival in this DM-CTO population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary*
  • Case-Control Studies
  • Coronary Angiography
  • Coronary Disease / complications
  • Coronary Disease / mortality
  • Coronary Disease / therapy*
  • Diabetic Angiopathies / complications
  • Diabetic Angiopathies / mortality
  • Diabetic Angiopathies / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Treatment Outcome