Angiographic complete revascularization versus incomplete revascularization in patients with diabetes mellitus View Full Text


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Article Info

DATE

2022-04-19

AUTHORS

Doyeon Hwang, Jiesuck Park, Han-Mo Yang, Seokhun Yang, Jeehoon Kang, Jung-Kyu Han, Kyung Woo Park, Hyun-Jae Kang, Bon-Kwon Koo, Hyo-Soo Kim

ABSTRACT

BackgroundConsidering the nature of diabetes mellitus (DM) in coronary artery disease, it is unclear whether complete revascularization is beneficial or not in patients with DM. We investigated the clinical impact of angiographic complete revascularization in patients with DM.MethodsA total of 5516 consecutive patients (2003 patients with DM) who underwent coronary stenting with 2nd generation drug-eluting stent were analyzed. Angiographic complete revascularization was defined as a residual SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) score of 0. The patient-oriented composite outcome (POCO, including all-cause death, any myocardial infarction, and any revascularization) and target lesion failure (TLF) at three years were analyzed.ResultsComplete revascularization was associated with a reduced risk of POCO in DM population [adjusted hazard ratio (HR) 0.70, 95% confidence interval (CI) 0.52–0.93, p = 0.016], but not in non-DM population (adjusted HR 0.90, 95% CI 0.69–1.17, p = 0.423). The risk of TLF was comparable between the complete and incomplete revascularization groups in both DM (adjusted HR 0.75, 95% CI 0.49–1.16, p = 0.195) and non-DM populations (adjusted HR 1.11, 95% CI 0.75–1.63, p = 0.611). The independent predictors of POCO were incomplete revascularization, multivessel disease, left main disease and low ejection fraction in the DM population, and old age, peripheral vessel disease, and low ejection fraction in the non-DM population.ConclusionsThe clinical benefit of angiographic complete revascularization is more prominent in patients with DM than those without DM after three years of follow-up. Relieving residual disease might be more critical in the DM population than the non-DM population.Trial registration The Grand Drug-Eluting Stent registry NCT03507205. More... »

PAGES

56

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12933-022-01488-7

DOI

http://dx.doi.org/10.1186/s12933-022-01488-7

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https://app.dimensions.ai/details/publication/pub.1147218940

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35439958


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