effects of coronary stenting on vessel patency and long-term clinical outcome after percutaneous coronary revascularization in diabetic patients

We sought to compare coronary stent implantation with balloon angioplasty (BA), in a diabetic population, in terms of the six-month angiographic outcome and four-year clinical events. Diabetic patients have a poor angiographic and clinical outcome after standard coronary BA. To date, it is still unc...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of the American College of Cardiology Vol. 40; no. 3; pp. 410 - 417
Main Authors:	Van Belle, Eric, Périé, Marc, Braune, David, Chmaït, Akram, Meurice, Thibaud, Abolmaali, Kaveh, McFadden, Eugène P., Bauters, Christophe, Lablanche, Jean-Marc, Bertrand, Michel E.
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 07-08-2002 Elsevier Science Elsevier Limited
Subjects:	Aged Angioplasty Angioplasty, Balloon, Coronary Biological and medical sciences Blood Vessel Prosthesis Implantation Cardiology Coronary Restenosis - diagnostic imaging Coronary Restenosis - etiology Coronary Restenosis - physiopathology Coronary Stenosis - diagnostic imaging Coronary Stenosis - mortality Coronary Stenosis - therapy Coronary vessels Coronary Vessels - physiopathology Coronary Vessels - surgery Diabetes Mellitus - mortality Diabetes Mellitus - therapy Diseases of the cardiovascular system Endpoint Determination Female Follow-Up Studies France Heart attacks Humans Male Medical sciences Middle Aged Radiography Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Stents Stroke Volume - physiology Studies Survival Analysis Time Treatment Outcome Vascular Patency - physiology EPISTENT MLD SVG TIMI PTCA LVEF LV MI ARTS PCR BA Endocrinopathy Human Endoprosthesis Prognosis Diabetes mellitus Mortality Coronary artery Instrumentation therapy Cuffed tube Instrumental dilatation Percutaneous route Treatment Follow up study Comparative study
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	We sought to compare coronary stent implantation with balloon angioplasty (BA), in a diabetic population, in terms of the six-month angiographic outcome and four-year clinical events. Diabetic patients have a poor angiographic and clinical outcome after standard coronary BA. To date, it is still unclear whether stent implantation may improve this outcome. We investigated this issue by individual matching of 314 diabetic patients treated with either coronary stenting or standard BA. These two groups were derived from a population of consecutive diabetic patients (1993 to 1996). Matching criteria were gender, anti-diabetic regimen, stenosis location, reference diameter, and minimal luminal diameter (±0.4 mm). One lesion per patient was considered for matching. Baseline characteristics were similar between the two groups of 157 patients. At six months, the rates of restenosis (27% vs. 62%; p < 0.0001) and occlusion (4% vs. 13%; p < 0.005) were lower in the stent group than in the BA group. This was associated with a significant decrease in ejection fraction at six months in the BA group (p = 0.02) while, during the same period, no change was observed in the stent group (p = NS). Subgroup analysis demonstrated that angiographic benefit was consistent among the subgroups. At four years, the combined clinical end point of cardiac death and non-fatal myocardial infarction was lower in the stent group (14.8% vs. 26.0%; p = 0.02), as was the need for repeat revascularization (35.4% vs. 52.1%; p = 0.001). In a population of diabetic patients, coronary stent implantation was associated with a highly beneficial effect on the six-month angiographic outcome and four-year clinical events compared with standard BA.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0735-1097 1558-3597
DOI:	10.1016/S0735-1097(02)01971-X