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Comparative Study
. 2015 Dec;26(8):699-705.
doi: 10.1097/MCA.0000000000000304.

Comparison of 12-month clinical outcomes in diabetic and nondiabetic patients with chronic total occlusion lesions: a multicenter study

Seung-Woon Rha  1 , Cheol Ung Choi, Jin Oh Na, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Hyeon-Cheol Gwon, Byeong-Keuk Kim, Hyo-Soo Kim, Cheol Woong Yu, Hun Sik Park, In-Ho Chae, Seung-Hwan Lee, Moo Hyun Kim, Seung-Ho Hur, Young-Keun Ahn, Yangsoo Jang
Affiliations
Comparative Study

Comparison of 12-month clinical outcomes in diabetic and nondiabetic patients with chronic total occlusion lesions: a multicenter study

Seung-Woon Rha et al. Coron Artery Dis. 2015 Dec.

Abstract

Objective: This study aimed to compare 1-year clinical outcomes in diabetic and nondiabetic patients with chronic total occlusion (CTO) lesions.

Methods: A total of 2865 patients (age 62.82±10.64 years; 74.0% men) undergoing percutaneous coronary intervention for CTO were analyzed. The patients were classified as diabetic (n=977) or nondiabetic (n=1888). One-year clinical outcomes were compared between the two groups.

Results: One year after percutaneous coronary intervention, 241 (8.4%) patients developed major adverse cardiac events (MACEs). Target lesion revascularization (TLR), target vessel revascularization (TVR), TLR-MACEs, and total MACEs were more common in diabetics than in nondiabetics (6.1 vs. 3.9%, P=0.021; 7.2 vs. 4.8%, P=0.023; 7.7 vs. 5.5%, P=0.017; and 10.3 vs. 7.7%, P=0.011; respectively). In multivariate analysis, diabetes mellitus was an independent predictor for 1-year TLR (odds ratio: 2.201, P=0.001) and total MACEs (odds ratio: 1.677, P=0.002). Among diabetic patients, total death, TLR, TVR, TLR-MACEs, TVR-MACEs, and total MACEs were more common in patients who used insulin than in those who did not (6.1 vs. 1.9%, P=0.018; 11.3 vs. 4.6%, P=0.007; 12.2 vs. 5.9%, P=0.025; 14.8 vs. 5.9%, P=0.003; 16.5 vs. 8.0%, P=0.008; and 17.4 vs. 9.2%, P=0.012, respectively). Insulin use was an independent predictor for total death, 12-month TLR, TVR, TLR-MACEs, TVR-MACEs, and total MACEs.

Conclusion: This study identified diabetes mellitus as an independent risk factor for 1-year TLR and total MACEs in patients with CTO lesions.

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Figures

Fig. 1
Fig. 1
Clinical outcomes at 12 months in the DM group and the non-DM group. P<0.05 was considered statistically significant. DM, diabetes mellitus; MACEs, major adverse cardiac events; MI, myocardial infarction; TLR, target lesion revascularization; TVR, target vessel revascularization.
Fig. 2
Fig. 2
Clinical outcomes at 12 months in the DM group and the non-DM group among propensity-matched patients. P<0.05 was considered statistically significant. DM, diabetes mellitus; MACEs, major adverse cardiac events; MI, myocardial infarction; TLR, target lesion revascularization; TVR, target vessel revascularization.
Fig. 3
Fig. 3
Clinical outcomes at 12 months in the insulin-using and the noninsulin-using group among diabetic patients. P<0.05 was considered statistically significant. MACEs, major adverse cardiac events; MI, myocardial infarction; TLR, target lesion revascularization; TVR, target vessel revascularization.
See this image and copyright information in PMC

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