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. 2018 Dec 10;13(12):e0208746.
doi: 10.1371/journal.pone.0208746. eCollection 2018.

Impact of diabetes mellitus in patients undergoing contemporary percutaneous coronary intervention: Results from a Korean nationwide study

Yujin Yang  1 , Gyung-Min Park  1 , Seungbong Han  2 , Yong-Giun Kim  1 , Jon Suh  3 , Hyun Woo Park  3 , Ki-Bum Won  1 , Soe Hee Ann  1 , Shin-Jae Kim  1 , Dae-Won Kim  4 , Mahn-Won Park  4 , Sung Ho Her  4 , Sang-Gon Lee  1
Affiliations

Impact of diabetes mellitus in patients undergoing contemporary percutaneous coronary intervention: Results from a Korean nationwide study

Yujin Yang et al. PLoS One. .

Abstract

Objectives: Despite an obvious improvement in the treatment of coronary artery disease (CAD) and survival rate of patients with CAD during recent decades, diabetes mellitus (DM) is still considered a risk factor of adverse clinical outcomes in these patients. Therefore, we sought to evaluate the clinical implications of DM in patients with CAD who underwent contemporary percutaneous coronary intervention (PCI).

Methods: Based on the National Health Insurance claims data in South Korea, patients aged 18 years or older who had undergone PCI for the diagnosis of CAD between 2011 and 2015 were analyzed. Patients were classified into the DM (n = 26,872) and non-DM (n = 54,243) groups. The primary endpoint was all-cause mortality, and it was compared between the two groups via a propensity score matching analysis.

Results: The study population was categorized as patients with angina (n = 49,228) or acute myocardial infarction (AMI, n = 31,887). The study population had a median follow-up of 2.1 years (interquartile range, 1.1-3.2). After the propensity score matching analysis, 8,157 and 4,266 pairs of patients with angina and AMI were identified, respectively. In the matched angina group, the incidence of all-cause death was significantly higher in patients with DM (adjusted hazard ratio [aHR]: 1.30; 95% confidence interval [CI]: 1.16-1.47; p<0.001) than in those without DM. Moreover, in the matched AMI group, the incidence of all-cause death was significantly higher in patients with DM (aHR: 1.35; 95% CI: 1.19-1.53; p<0.001) than in those without DM.

Conclusions: In patients undergoing contemporary PCI in Korea, the presence of DM was associated with poorer clinical outcomes.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig 1
Fig 1. Overview of the study population.
CAD = coronary artery disease; DM = diabetes mellitus; HIRA = Health Insurance Review & Assessment Service; AMI = acute myocardial infarction; PCI = percutaneous coronary intervention.
Fig 2
Fig 2. Cumulative incidence rates for all-cause deaths in the study population.
Cumulative incidence rates for (A) all-cause death in patients with angina and (B) in those with acute myocardial infarction. The numbers in each figure represent the cumulative incidence rates at each time point. AMI = acute myocardial infarction.
See this image and copyright information in PMC

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