Percutaneous Coronary Interventions in Diabetic Patients: Is Complete Revascularization Important?

Eugenia Nikolsky, Luis Gruberg, Chandrashekhar V. Patil, Ariel Roguin, Michael Kapeliovich, Sirouch Petcherski, Monther Boulos, Ehud Grenadier, Shlomo Amikam, Shai Linn, Walter Markiewicz, Rafael Beyar

Research output: Contribution to journalArticlepeer-review

Abstract

Background. The long-term prognosis of diabetic patients with multivessel coronary artery disease (CAD) treated by surgical or percutaneous coronary revascularization is significantly worse as compared to non-diabetics. Lower rates of complete revascularization may be one factor that influences the poor long-term outcome in the diabetic population. Our study assessed the impact of complete revascularization on the long-term prognosis in diabetic patients with CAD treated by percutaneous coronary intervention (PCI). The study included 658 consecutive diabetic patients (mean age, 60.9 ± 10.1 years) who underwent PCI. Multivessel disease was present in 352 patients (53.5%). Revascularization was complete in 94 (26.7%) and incomplete in 258 (73.3%) patients with multivessel disease. Reasons for incomplete revascularization included angioplasty of only the culprit lesion (43.4%); small vessel size (22.8%); moderate lesion, defined as diameter stenosis 50-69% (18.6%); chronic total occlusion of the non-intervened vessel (6.6%); and others (8.5%). Overall survival rate at 5 years was 87.4%. Patients who underwent complete revascularization had a 94.5% survival rate, compared to 83.0% for those with incomplete revascularization (p <0.001). Similarly, the rates of myocardial infarction-free survival were significantly higher in patients with complete versus incomplete revascularization (92.9% versus 79.9%, respectively). Incomplete revascularization was the most powerful independent predictor of mortality at follow-up (relative risk 95% confidence interval, 1.54-7.69; p = 0.003). Our data suggest that complete myocardial revascularization may improve the long-term prognosis after PCI of diabetic patients with multivessel CAD.

Original languageEnglish (US)
Pages (from-to)102-106
Number of pages5
JournalJournal of Invasive Cardiology
Volume16
Issue number3
StatePublished - Mar 2004
Externally publishedYes

Keywords

  • Coronary artery disease
  • Restenosis
  • Revascularization
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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