Long-term results after drug-eluting stent implantation in diabetic patients according to diabetic treatment

Vassilis Voudris, Panagiotis Karyofillis, Sofia Thomopoulou, Constantinos Doulaptsis, Athanasios Manginas, Gregory Pavlides, Dennis V. Cokkinos

Research output: Contribution to journalArticle

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Abstract

Introduction: In this prospective, single-center study we assessed the long-term results after drug-eluting stent implantation in non insulin-dependent diabetic patients compared to insulin-dependent patients. Methods: A total of 610 consecutive diabetic patients (mean age 65 ± 9 years) underwent percutaneous coronary intervention with drug-eluting stent implantation. They were classified into 2 groups according to their diabetic treatment: 1) non insulin-dependent patients (477); 2) insulin-dependent patients (133). The primary endpoint was the composite of death, non-fatal myocardial infarction, bypass surgery and target lesion revascularization. Results: Clinical follow up for more than 12 months (median 29 months) was achieved in 597/610 patients (98%). The insulin-dependent group had more women (29% vs. 18%, p=0.003), as well as a higher incidence of multivessel disease (84% vs. 65%, p<0.0001) and ejection fraction <40% (16% vs. 9%, p=0.037) compared to the non insulin-dependent group. The in-hospital results were almost the same in both groups, except for the incidence of non-Q myocardial infarction and bleeding complications, which were more frequent in the insulin-dependent group (9.8% vs. 4.8%, p=0.03, and 1.5% vs. 0%, p=0.047, respectively). During clinical follow up, no significant differences in the incidence of death or non-fatal myocardial infarction were observed, but target lesion revascularization and bypass surgery were more frequent in the insulin-dependent group (8.5% vs. 3.4%, p=0.01, and 4.7% vs. 1.3%, p=0.01, respectively). The event-free survival was lower in the insulin-dependent group (hazard ratio: 0.52; 95% confidence interval, 0.31-0.85, p=0.01). Conclusion: The implantation of drug-eluting stents in diabetics is associated with excellent in-hospital and long-term results. However, the long-term effectiveness in insulin-dependent patients is lower, because of the greater risk of new revascularization.

Original languageEnglish (US)
Pages (from-to)15-22
Number of pages8
JournalHellenic Journal of Cardiology
Volume52
Issue number1
StatePublished - Jan 1 2011

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Drug-Eluting Stents
Insulin
Therapeutics
Myocardial Infarction
Incidence
Percutaneous Coronary Intervention
Disease-Free Survival
Confidence Intervals
Hemorrhage

Keywords

  • Angioplasty
  • Coronary artery disease
  • Diabetes mellitus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Voudris, V., Karyofillis, P., Thomopoulou, S., Doulaptsis, C., Manginas, A., Pavlides, G., & Cokkinos, D. V. (2011). Long-term results after drug-eluting stent implantation in diabetic patients according to diabetic treatment. Hellenic Journal of Cardiology, 52(1), 15-22.

Long-term results after drug-eluting stent implantation in diabetic patients according to diabetic treatment. / Voudris, Vassilis; Karyofillis, Panagiotis; Thomopoulou, Sofia; Doulaptsis, Constantinos; Manginas, Athanasios; Pavlides, Gregory; Cokkinos, Dennis V.

In: Hellenic Journal of Cardiology, Vol. 52, No. 1, 01.01.2011, p. 15-22.

Research output: Contribution to journalArticle

Voudris, V, Karyofillis, P, Thomopoulou, S, Doulaptsis, C, Manginas, A, Pavlides, G & Cokkinos, DV 2011, 'Long-term results after drug-eluting stent implantation in diabetic patients according to diabetic treatment', Hellenic Journal of Cardiology, vol. 52, no. 1, pp. 15-22.
Voudris V, Karyofillis P, Thomopoulou S, Doulaptsis C, Manginas A, Pavlides G et al. Long-term results after drug-eluting stent implantation in diabetic patients according to diabetic treatment. Hellenic Journal of Cardiology. 2011 Jan 1;52(1):15-22.
Voudris, Vassilis ; Karyofillis, Panagiotis ; Thomopoulou, Sofia ; Doulaptsis, Constantinos ; Manginas, Athanasios ; Pavlides, Gregory ; Cokkinos, Dennis V. / Long-term results after drug-eluting stent implantation in diabetic patients according to diabetic treatment. In: Hellenic Journal of Cardiology. 2011 ; Vol. 52, No. 1. pp. 15-22.
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abstract = "Introduction: In this prospective, single-center study we assessed the long-term results after drug-eluting stent implantation in non insulin-dependent diabetic patients compared to insulin-dependent patients. Methods: A total of 610 consecutive diabetic patients (mean age 65 ± 9 years) underwent percutaneous coronary intervention with drug-eluting stent implantation. They were classified into 2 groups according to their diabetic treatment: 1) non insulin-dependent patients (477); 2) insulin-dependent patients (133). The primary endpoint was the composite of death, non-fatal myocardial infarction, bypass surgery and target lesion revascularization. Results: Clinical follow up for more than 12 months (median 29 months) was achieved in 597/610 patients (98{\%}). The insulin-dependent group had more women (29{\%} vs. 18{\%}, p=0.003), as well as a higher incidence of multivessel disease (84{\%} vs. 65{\%}, p<0.0001) and ejection fraction <40{\%} (16{\%} vs. 9{\%}, p=0.037) compared to the non insulin-dependent group. The in-hospital results were almost the same in both groups, except for the incidence of non-Q myocardial infarction and bleeding complications, which were more frequent in the insulin-dependent group (9.8{\%} vs. 4.8{\%}, p=0.03, and 1.5{\%} vs. 0{\%}, p=0.047, respectively). During clinical follow up, no significant differences in the incidence of death or non-fatal myocardial infarction were observed, but target lesion revascularization and bypass surgery were more frequent in the insulin-dependent group (8.5{\%} vs. 3.4{\%}, p=0.01, and 4.7{\%} vs. 1.3{\%}, p=0.01, respectively). The event-free survival was lower in the insulin-dependent group (hazard ratio: 0.52; 95{\%} confidence interval, 0.31-0.85, p=0.01). Conclusion: The implantation of drug-eluting stents in diabetics is associated with excellent in-hospital and long-term results. However, the long-term effectiveness in insulin-dependent patients is lower, because of the greater risk of new revascularization.",
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AU - Manginas, Athanasios

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AU - Cokkinos, Dennis V.

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N2 - Introduction: In this prospective, single-center study we assessed the long-term results after drug-eluting stent implantation in non insulin-dependent diabetic patients compared to insulin-dependent patients. Methods: A total of 610 consecutive diabetic patients (mean age 65 ± 9 years) underwent percutaneous coronary intervention with drug-eluting stent implantation. They were classified into 2 groups according to their diabetic treatment: 1) non insulin-dependent patients (477); 2) insulin-dependent patients (133). The primary endpoint was the composite of death, non-fatal myocardial infarction, bypass surgery and target lesion revascularization. Results: Clinical follow up for more than 12 months (median 29 months) was achieved in 597/610 patients (98%). The insulin-dependent group had more women (29% vs. 18%, p=0.003), as well as a higher incidence of multivessel disease (84% vs. 65%, p<0.0001) and ejection fraction <40% (16% vs. 9%, p=0.037) compared to the non insulin-dependent group. The in-hospital results were almost the same in both groups, except for the incidence of non-Q myocardial infarction and bleeding complications, which were more frequent in the insulin-dependent group (9.8% vs. 4.8%, p=0.03, and 1.5% vs. 0%, p=0.047, respectively). During clinical follow up, no significant differences in the incidence of death or non-fatal myocardial infarction were observed, but target lesion revascularization and bypass surgery were more frequent in the insulin-dependent group (8.5% vs. 3.4%, p=0.01, and 4.7% vs. 1.3%, p=0.01, respectively). The event-free survival was lower in the insulin-dependent group (hazard ratio: 0.52; 95% confidence interval, 0.31-0.85, p=0.01). Conclusion: The implantation of drug-eluting stents in diabetics is associated with excellent in-hospital and long-term results. However, the long-term effectiveness in insulin-dependent patients is lower, because of the greater risk of new revascularization.

AB - Introduction: In this prospective, single-center study we assessed the long-term results after drug-eluting stent implantation in non insulin-dependent diabetic patients compared to insulin-dependent patients. Methods: A total of 610 consecutive diabetic patients (mean age 65 ± 9 years) underwent percutaneous coronary intervention with drug-eluting stent implantation. They were classified into 2 groups according to their diabetic treatment: 1) non insulin-dependent patients (477); 2) insulin-dependent patients (133). The primary endpoint was the composite of death, non-fatal myocardial infarction, bypass surgery and target lesion revascularization. Results: Clinical follow up for more than 12 months (median 29 months) was achieved in 597/610 patients (98%). The insulin-dependent group had more women (29% vs. 18%, p=0.003), as well as a higher incidence of multivessel disease (84% vs. 65%, p<0.0001) and ejection fraction <40% (16% vs. 9%, p=0.037) compared to the non insulin-dependent group. The in-hospital results were almost the same in both groups, except for the incidence of non-Q myocardial infarction and bleeding complications, which were more frequent in the insulin-dependent group (9.8% vs. 4.8%, p=0.03, and 1.5% vs. 0%, p=0.047, respectively). During clinical follow up, no significant differences in the incidence of death or non-fatal myocardial infarction were observed, but target lesion revascularization and bypass surgery were more frequent in the insulin-dependent group (8.5% vs. 3.4%, p=0.01, and 4.7% vs. 1.3%, p=0.01, respectively). The event-free survival was lower in the insulin-dependent group (hazard ratio: 0.52; 95% confidence interval, 0.31-0.85, p=0.01). Conclusion: The implantation of drug-eluting stents in diabetics is associated with excellent in-hospital and long-term results. However, the long-term effectiveness in insulin-dependent patients is lower, because of the greater risk of new revascularization.

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