Copyright © 2002 by the European Society of Cardiology.
Comparative outcomes of percutaneous coronary interventions in diabetics vs non-diabetics with prior coronary artery bypass grafting
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.
revised December 11, 2001; accepted December 12, 2001
Abstract
Aims To determine the influence of diabetes on outcome after percutaneous coronary intervention in patients with prior coronary artery bypass grafting.
Methods and Results Patients with prior coronary artery bypass grafting undergoing percutaneous coronary intervention from 1 January 1996, to 31 August 2000, were divided into two groups based on whether or not they had diabetes, excluding patients with acute infarction or shock. Cox proportional hazards models were utilized to estimate the association between diabetes and adverse events. One thousand one hundred and fifty-three post-coronary artery bypass grafting percutaneous coronary intervention patients were identified (326 diabetics and 827 non-diabetics). Diabetics were younger, more likely to have hypertension, heart failure, and lower ejection fraction. Procedural characteristics and angiographic and procedural success rates were similar. Diabetes was associated with increased mortality (hazard ratio 1·58, 95% confidence intervals 1·10–2·27). Diabetes did not have a significant effect on mortality in patients treated for single-territory coronary disease (hazard ratio 1·44, 95% confidence intervals 0·69–3·02), but did in patients with multi-territory disease (hazard ratio 1·79, 95% confidence intervals 1·16–2·76). However, in diabetics with multi-territory disease who were completely revascularized with percutaneous coronary intervention, mortality was comparable to non-diabetics (hazard ratio 1·32, 95% confidence intervals 0·57–3·03).
Conclusion Among percutaneous coronary intervention patients with prior coronary artery bypass grafting, diabetes portends an adverse prognosis.Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved .
Key Words: Coronary artery bypass grafting, diabetes, percutaneous coronary intervention, mortality
f1 Correspondence: Verghese Mathew, MD, Division of Cardiovascular Diseases, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, U.S.A.
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