The following is an abstract of the study “Impact of Diabetes on Clinical Outcomes After Primary In-Stent Restenosis PCI: Results From a Large Registry” published in the April 2024 issue. Cardiology Tanner et al.
Patients with diabetes mellitus (DM) are at increased risk of major adverse cardiac events (MACE) after de novo percutaneous coronary intervention (PCI).
Researchers conducted a retrospective study to determine whether DM patients undergoing PCI for in-stent restenosis (ISR) experience a similar risk for cardiac problems.
They compared clinical outcomes between patients with DM and those without DM who underwent PCI for ISR for the first time between January 2015 and December 2021. The primary endpoint of the study was MACE (all-cause mortality, myocardial infarction). [MI]and target lesion revascularization [TVR]) in one year.
Results showed that 3,156 patients underwent ISR PCI (56.7% with DM). Patients with DM were younger, more likely to be female, and more likely to have other health problems. At 1-year follow-up, DM was associated with a higher incidence of MACE (22.4% vs. 18.7%, unadjusted HR 2.03, 95% CI (1.27-3.25)). P= 0.003). At 1-year follow-up, all-cause mortality and myocardial infarction were also more common in patients with DM. TVR rates were similar in both groups (17.9% vs. 16.0%, unadjusted HR 1.14, 95% CI (0.94-1.37)). PIn adjusted analyses, there was no significant difference in the incidence of MACE (AHR 1.07, 95% CI (0.90-1.29); P=0.444), and all-cause mortality (AHR 1.54, 95%CI 0.01–0.49; [0.93-2.54], P= 0.095) or MI (AHR 1.10, 95% CI 0.01–0.53; [0.74-1.63], P=0.652).
The researchers concluded that the initially higher incidence of MACE at 1-year follow-up in patients undergoing ISR PCI did not persist after accounting for baseline factors.
sauce: Science Direct
