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Meta-Analysis
. 2019 Feb;98(8):e14669.
doi: 10.1097/MD.0000000000014669.

In-hospital, short-term and long-term adverse clinical outcomes observed in patients with type 2 diabetes mellitus vs non-diabetes mellitus following percutaneous coronary intervention: A meta-analysis including 139,774 patients

Xiaojun Zhuo  1 , Chuanzeng Zhang  2 , Juan Feng  1 , Shenyu Ouyang  1 , Pei Niu  1 , Zhaohui Dai  1
Affiliations
Meta-Analysis

In-hospital, short-term and long-term adverse clinical outcomes observed in patients with type 2 diabetes mellitus vs non-diabetes mellitus following percutaneous coronary intervention: A meta-analysis including 139,774 patients

Xiaojun Zhuo et al. Medicine (Baltimore). 2019 Feb.

Abstract

Background: Several studies have shown that patients with type 2 diabetes mellitus (T2DM) have worse clinical outcomes in comparison to patients without diabetes mellitus (DM) following Percutaneous Coronary Intervention (PCI). However, the adverse clinical outcomes were not similarly reported in all the studies. Therefore, in order to standardize this issue, a meta-analysis including 139,774 patients was carried out to compare the in-hospital, short-term (<1 year) and long-term (≥1 year) adverse clinical outcomes in patients with and without T2DM following PCI.

Methods: Electronic databases including MEDLINE, EMBASE, and the Cochrane Library were searched for Randomized Controlled Trials (RCTs) and observational studies. The adverse clinical outcomes which were analyzed included mortality, myocardial infarction (MI), major adverse cardiac events (MACEs), stroke, bleeding, target vessel revascularization (TVR), target lesion revascularization (TLR), and stent thrombosis. Risk Ratios (RR) with 95% confidence intervals (CI) were used to express the pooled effect on discontinuous variables and the analysis was carried out by RevMan 5.3 software.

Results: A total number of 139,774 participants were assessed. Results of this analysis showed that in-hospital mortality and MACEs were significantly higher in patients with T2DM (RR 2.57; 95% CI: 1.95-3.38; P = .00001) and (RR: 1.38; 95% CI: 1.10-1.73; P = .005) respectively. In addition, majority of the short and long-term adverse clinical outcomes were also significantly higher in the DM group as compared to the non-DM group. Stent thrombosis was significantly higher in the DM compared to the non-DM group during the short term follow-up period (RR 1.59; 95% CI: 1.16-2.18;P = .004). However, long-term stent thrombosis was similarly manifested.

Conclusion: According to this meta-analysis including a total number of 139,774 patients, following PCI, those patients with T2DM suffered more in-hospital, short as well as long-term adverse outcomes as reported by most of the Randomized Controlled Trials and Observational studies, compared to those patients without diabetes mellitus.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow diagram representing the study selection.
Figure 2
Figure 2
Forest plot comparing the in-hospital adverse clinical outcomes observed in patients with vs without type 2 diabetes mellitus following PCI. PCI = percutaneous coronary intervention.
Figure 3
Figure 3
Forest plot comparing the short-term adverse clinical outcomes observed in patients with vs without type 2 diabetes mellitus following PCI. PCI = percutaneous coronary intervention.
Figure 4
Figure 4
Forest plot comparing 1 year adverse clinical outcomes observed in patients with vs without type 2 diabetes mellitus following PCI. PCI = percutaneous coronary intervention.
Figure 5
Figure 5
Forest plot comparing the long-term (>1 year) adverse clinical outcomes observed in patients with vs without type 2 diabetes mellitus following PCI. PCI = percutaneous coronary intervention.
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