The following is a summary of “Impact of diabetes mellitus on clinical outcomes after first episode in-stent restenosis PCI: Results from a large registry,” published in the April 2024 issue of Cardiology by Tanner et al.
Patients with Diabetes Mellitus (DM) have a higher risk of major adverse cardiac events (MACE) following de novo percutaneous coronary intervention (PCI) in coronary arteries.
Researchers conducted a retrospective study to determine whether patients with DM undergoing PCI for in-stent restenosis (ISR) experience the same risk of heart issues.
They compared the clinical outcomes of patients with and without DM who underwent PCI for ISR for the first time between January 2015 and December 2021. The primary outcome of this study was MACE (all-cause death, myocardial infarction [MI], and target lesion revascularization [TVR]) at one year.
The results showed 3,156 patients had ISR PCI (56.7% with DM). Patients with DM were younger, more often female, and had more other health issues. At 1-year follow-up, DM was associated with a higher rate of MACE (22.4% vs. 18.7%, unadjusted HR 2.03, 95%CI (1.27-3.25), P=0.003). All-cause mortality and MI were also more frequent among people with DM at 1-year follow-up. The TVR rates were similar in both groups (17.9% vs. 16.0%, unadjusted HR 1.14, 95%CI (0.94-1.37), P=0.180). On adjusted analysis, there was no significant difference in the rate of MACE (AHR 1.07, 95%CI (0.90 ‐ –1.29), P=0.444), all-cause mortality (AHR 1.54, 95%CI [0.93-2.54], P=0.095) or MI (AHR 1.10, 95%CI [0.74-1.63], P=0.652).
Investigators concluded that the initial higher rate of MACE at 1-year follow-up in patients undergoing ISR PCI was not sustained after considering baseline factors.
Source: sciencedirect.com/science/article/abs/pii/S0167527324002638
