Outcomes in Patients with Diabetes Mellitus According to Insulin Treatment After Percutaneous Coronary Intervention in the Second-Generation Drug-Eluting Stent Era

医学 经皮冠状动脉介入治疗 传统PCI 内科学 心脏病学 危险系数 心肌梗塞 糖尿病 人口 血运重建 置信区间 环境卫生 内分泌学
作者
Seung-Hoon Pi,Tae‐Min Rhee,Joo Myung Lee,Doyeon Hwang,Jonghanne Park,Taek Kyu Park,Jeong Hoon Yang,Young Bin Song,Jin‐Ho Choi,Joo‐Yong Hahn,Byung Jin Kim,Bum Soo Kim,Hyeon–Cheol Gwon,Seung‐Hyuk Choi
出处
期刊:American Journal of Cardiology [Elsevier BV]
卷期号:121 (12): 1505-1511 被引量:25
标识
DOI:10.1016/j.amjcard.2018.02.034
摘要

Limited data exist regarding the clinical outcomes of patients with diabetes mellitus (DM) after percutaneous coronary intervention (PCI) using second-generation drug-eluting stents (DES), especially according to DM treatment. The purpose of this study was to compare clinical outcomes among patients without DM, with non-insulin-treated DM (non-ITDM), and with ITDM after PCI using second-generation DES. We analyzed 4,812 consecutive patients who underwent PCI using second-generation DES. Primary outcomes were patient-oriented composite outcome (a composite of all-cause mortality, any myocardial infarction, and any revascularization) at 3 years. Among the total population, 3,026 patients have no DM, 1,169 have non-ITDM, and 617 have ITDM. Patients with DM, regardless of non-ITDM and ITDM, showed significantly higher risk of patient-oriented composite outcome (21.0% vs 14.5%; adjusted hazard ratio [HRadj]1.41, 95% confidence interval [CI] 1.19 to 1.66, p <0.001), mainly driven by significantly higher risk of cardiac death and any revascularization compared with non-DM. Among DM population, ITDM showed significantly higher risk of cardiac death (7.7% vs 3.7%; HRadj 1.97, 95% CI 1.19 to 3.27, p = 0.009), any revascularization (17.0% vs 11.4%; HRadj 1.40, 95% CI 1.01 to 1.93, p = 0.041), and definite/probable stent thrombosis (1.7% vs 0.7%; HRadj 2.80, 95% CI 1.04 to 7.56, p = 0.042) compared with non-ITDM. In conclusion, even in the era of second-generation DES, patients with DM are at significantly higher risk of patient-oriented adverse events. Among these, patients with ITDM showed the highest risk of adverse events, mainly driven by higher risk of mortality, any revascularization, and definite/probable stent thrombosis. Limited data exist regarding the clinical outcomes of patients with diabetes mellitus (DM) after percutaneous coronary intervention (PCI) using second-generation drug-eluting stents (DES), especially according to DM treatment. The purpose of this study was to compare clinical outcomes among patients without DM, with non-insulin-treated DM (non-ITDM), and with ITDM after PCI using second-generation DES. We analyzed 4,812 consecutive patients who underwent PCI using second-generation DES. Primary outcomes were patient-oriented composite outcome (a composite of all-cause mortality, any myocardial infarction, and any revascularization) at 3 years. Among the total population, 3,026 patients have no DM, 1,169 have non-ITDM, and 617 have ITDM. Patients with DM, regardless of non-ITDM and ITDM, showed significantly higher risk of patient-oriented composite outcome (21.0% vs 14.5%; adjusted hazard ratio [HRadj]1.41, 95% confidence interval [CI] 1.19 to 1.66, p <0.001), mainly driven by significantly higher risk of cardiac death and any revascularization compared with non-DM. Among DM population, ITDM showed significantly higher risk of cardiac death (7.7% vs 3.7%; HRadj 1.97, 95% CI 1.19 to 3.27, p = 0.009), any revascularization (17.0% vs 11.4%; HRadj 1.40, 95% CI 1.01 to 1.93, p = 0.041), and definite/probable stent thrombosis (1.7% vs 0.7%; HRadj 2.80, 95% CI 1.04 to 7.56, p = 0.042) compared with non-ITDM. In conclusion, even in the era of second-generation DES, patients with DM are at significantly higher risk of patient-oriented adverse events. Among these, patients with ITDM showed the highest risk of adverse events, mainly driven by higher risk of mortality, any revascularization, and definite/probable stent thrombosis.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
薄雪草完成签到,获得积分10
刚刚
大橙子发布了新的文献求助10
刚刚
快乐学习每一天完成签到 ,获得积分10
刚刚
薄荷味完成签到 ,获得积分0
2秒前
科研通AI2S应助笑林采纳,获得10
2秒前
无心的雅旋完成签到,获得积分10
3秒前
量子星尘发布了新的文献求助10
4秒前
Horizon完成签到 ,获得积分10
8秒前
Oliver完成签到 ,获得积分10
10秒前
Superman完成签到 ,获得积分10
13秒前
Tina酱完成签到 ,获得积分10
13秒前
琪琪完成签到,获得积分10
13秒前
双碳小王子完成签到,获得积分10
15秒前
smottom应助科研通管家采纳,获得10
17秒前
17秒前
明时完成签到,获得积分10
18秒前
杨瑞东完成签到 ,获得积分10
21秒前
yyyy完成签到,获得积分10
29秒前
缥缈的平卉完成签到 ,获得积分10
30秒前
量子星尘发布了新的文献求助10
41秒前
李爱国应助大橙子采纳,获得10
42秒前
magictoo发布了新的文献求助30
48秒前
50秒前
yang完成签到,获得积分10
50秒前
Minicoper发布了新的文献求助10
51秒前
快乐丸子完成签到,获得积分10
52秒前
简单而复杂完成签到,获得积分10
52秒前
大橙子发布了新的文献求助10
56秒前
张牧之完成签到 ,获得积分10
58秒前
冷冷暴力完成签到,获得积分10
1分钟前
YYY完成签到,获得积分10
1分钟前
1分钟前
gujian完成签到 ,获得积分10
1分钟前
帅气的秘密完成签到 ,获得积分10
1分钟前
自然函发布了新的文献求助10
1分钟前
冰冰双双完成签到,获得积分10
1分钟前
开心夏旋完成签到 ,获得积分0
1分钟前
我要读博士完成签到 ,获得积分10
1分钟前
活泼的大船完成签到,获得积分10
1分钟前
AFF完成签到,获得积分10
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038128
求助须知:如何正确求助?哪些是违规求助? 3575831
关于积分的说明 11373827
捐赠科研通 3305610
什么是DOI,文献DOI怎么找? 1819255
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022