Insulin-treated diabetes mellitus and predictors of mid-term clinical outcome after percutaneous coronary interventions with stent implantation

Giuseppe Tarantini, Carlo Briguori, Goran Stankovic, Takuro Takagi, Nicola Corvaja, Carlo di Mario, Antonio Colombo

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Abstract

Background. Patients with type II, insulin-dependent diabetes mellitus have high risk of death and repeat revascularization following successful percutaneous coronary interventions. The predictors of outcome in such patients after coronary stenting have not been clarified. Methods. We studied 133 consecutive patients with type II, insulin-dependent diabetis mellitus who underwent coronary stenting from November 1992 to May 2001. The clinical outcome and predictors of major adverse cardiac events (MACE; that is death, myocardial infarction, target vessel revascularization) at follow-up were assessed. Results. Out of 133 patients, 102 (76%) had multivessel (≥ 2 vessels) disease. Eight patients (6.0%) had in-hospital MACE. Clinical fullow-up data at 19.5 months (range 6.1-100 months) were available for 121 (91%) patients. The MACE rate was 40.5%; 22 patients (18%) died, 17 (14%) of a cardiac death; 7 (5.8%) patients had a myocardial infarction, and target vessel revascularization was performed in 35 (28.9%) patients. At univariate analysis, hypertension (odds ratio-OR 5.5; confidence interval-CI-2.5-12.3; p <0.001), hypercholesterolemia (OR 3.7; CI 1.7-8.2; p = 0.001), a prior percutaneous coronary intervention (OR 6.6; CI 2.9-15.4; p <0.001), a prior myocardial infarction (OR 3.1; CI 1.5-6.7; p = 0.003) and the stent length (≥ 15 mm) (OR 2.7; CI 1.5-4.3; p = 0.008) were related to MACE. At multivariate analysis, hypertersion (OR 4.1; CI 1.7-9.9; p = 0.002), a prior percutaneous coronary intervention (OR 4.8; CI 1.9-12; p = 0.001) and the stent length (OR 3.0; CI 1.3-7.4; p = 0.01) remained as independent predictors of MACE. Conclusions. Patients with insulin-dependent diabetes mellitus continue to face a high mortality and incidence of adverse events after stenting. The occurrence of events was related t a history including hypertension, percutaneous coronary interventions and to the stent length.

Original languageEnglish
Pages (from-to)843-849
Number of pages7
JournalItalian Heart Journal
Volume4
Issue number12
Publication statusPublished - Dec 2003

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Keywords

  • Coronary artery disease
  • Diabetes
  • Mellitus
  • Prognosis
  • Stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Tarantini, G., Briguori, C., Stankovic, G., Takagi, T., Corvaja, N., di Mario, C., & Colombo, A. (2003). Insulin-treated diabetes mellitus and predictors of mid-term clinical outcome after percutaneous coronary interventions with stent implantation. Italian Heart Journal, 4(12), 843-849.