The following is a summary of “Optimal intravascular ultrasound-guided percutaneous coronary intervention in patients with multivessel disease and diabetes,” published in the May 2024 issue of Cardiology by Yamamoto et al.
The OPTIVUS-Complex PCI study explores outcomes of Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for patients with diabetes having multivessel disease, an area lacking prior data.
Researchers conducted a prospective study comparing the outcomes between patients with and without diabetes undergoing IVUS-guided multivessel PCI.
They enrolled 1,021 patients undergoing multivessel PCI with IVUS, focusing on optimal stent expansion criteria. Among them, 560 (54.8%, mean age [70.9±9.7]) had diabetes, and 461 (45.2%, mean age [71.7±10.4]) did not, and differences in outcomes were followed over a year.
The results showed that patients with diabetes were more likely to have chronic kidney disease (CKD) and complex coronary artery disease, as indicated by the number of stents and longer stent length. However, both groups met the criteria for optimal stent expansion at similar rates (61.2% vs. 60.7%, P=0.83), along with the cumulative 1-year incidence of the primary endpoint (10.8% vs. 9.8%, log-rank P=0.65). The risk of diabetes remained insignificant after adjusting confounders (HR, 0.97; 95% CI, 0.65-1.44; P=0.88). The primary outcome after a year (a combination of death, heart attack, stroke, or repeat revascularization) was similar in both groups.
Investigators concluded that even with diabetes, patients who had multivessel IVUS-guided PCI had similar outcomes after a year compared to those without diabetes, suggesting that current clinical practices work well for both groups.
Source: ajconline.org/article/S0002-9149(24)00335-7/abstract