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Diabet Med. 2017 Apr;34(4):558-562. doi: 10.1111/dme.13272. Epub 2016 Nov 3.

Impact of diabetes mellitus on acute outcomes of percutaneous coronary intervention in chronic total occlusions: insights from a US multicentre registry.

Author information

1
VA North Texas Healthcare System and UT Southwestern Medical Center, Dallas, TX, USA.
2
Columbia University, New York, NY, USA.
3
Henry Ford Hospital, Detroit, MI, USA.
4
Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
5
Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
6
VA San Diego Healthcare System and University of California San Diego, San Diego, CA, USA.
7
Medical Center of the Rockies, Loveland, CO, USA.
8
Boston Scientific, Natick, MA, USA.
9
Minneapolis Heart Institute, Minneapolis, MN, USA.

Abstract

AIM:

To examine the impact of diabetes mellitus on procedural outcomes of patients who underwent percutaneous coronary intervention for chronic total occlusion.

METHODS:

We assessed the impact of diabetes mellitus on the outcomes of percutaneous coronary intervention for chronic total occlusion among 1308 people who underwent such procedures at 11 US centres between 2012 and 2015.

RESULTS:

The participants' mean ± sd age was 66 ± 10 years, 84% of the participants were men and 44.6% had diabetes. As compared with participants without diabetes, participants with diabetes were more likely to have undergone coronary artery bypass graft surgery (38 vs 31%; P = 0.006), and to have had previous heart failure (35 vs 22%; P = 0.0001) and peripheral arterial disease (19 vs 13%; P = 0.002). They also had a higher BMI (31 ± 6 kg/m2 vs 29 ± 6 kg/m2 ; P = 0.001), similar Japanese chronic total occlusion scores (2.6 ± 1.2 vs 2.5 ± 1.2; P = 0.82) and similar final successful crossing technique: antegrade wire escalation (46 vs 47%; P = 0.66), retrograde (30 vs 28%; P = 0.66) and antegrade dissection re-entry (24 vs 25%; P = 0.66). Technical (91 vs 90%; P = 0.80) and procedural (89 vs 89%; P = 0.93) success was similar in the two groups, as was the incidence of major adverse cardiac events (2.2 vs 2.5%; P = 0.61).

CONCLUSIONS:

In a contemporary cohort of people undergoing percutaneous coronary intervention for chronic total occlusion, nearly one in two (45%) had diabetes mellitus. Procedural success and complication rates were similar in people with and without diabetes.

PMID:
27743404
PMCID:
PMC5352496
DOI:
10.1111/dme.13272
[Indexed for MEDLINE]
Free PMC Article

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