TCT-611 Clinical Outcomes After First Episode In-Stent Restenosis Percutaneous Coronary Intervention: Diabetics Versus Nondiabetics

Document Type

Conference Proceeding

Publication Date

10-24-2023

Publication Title

J Am Coll Cardiol

Abstract

Background: Diabetes mellitus is associated with an increased risk of in-stent restenosis (ISR) and major adverse cardiac events (MACE) after de novo lesion percutaneous coronary intervention (PCI). Whether diabetic patients undergoing PCI for ISR experience the same heighted risk for ISR and MACE is unknown. Methods: Patients with chronic coronary syndrome undergoing PCI between January 2015 and December 2021 for ISR at Mount Sinai Hospital were eligible for inclusion. The rate of MACE (all-cause death, myocardial infarction, and target lesion revascularization [TVR]) at 1-year follow-up was compared between diabetic and nondiabetic patients in an adjusted HR (AHR) model. Results: A total of 3,153 patients (1,791 diabetic patients [56.7%]) underwent PCI for ISR during the study period. Diabetic patients were younger (66.4 ± 10.1 years vs 68 ± 11.3 years; P < 0.001) and more likely to be female (27.2% vs 19.8%; P < 0.001). Furthermore, diabetic patients were more likely to have previous coronary artery bypass grafting, chronic kidney disease, and anemia, and have a high SYNTAX score. The proportion of patients treated for bifurcations, chronic total occlusions, and type B2/C lesions was similar in both groups. At 1-year follow-up, there was no significant difference in the rate of MACE between diabetic and nondiabetic patients (22.4% vs 18.7%, AHR: 1.12; 95% CI [0.94-1.34]; P = 0.27). All-cause mortality (4.1% vs 2.0%, AHR: 1.71; 95% CI [1.03-2.82]; P = 0.036) was significantly higher in diabetic patients, but there was no difference in the rates of TVR (17.9% vs 16.0%; AHR: 1.07; 95% CI [0.88-1.31]; P = 0.486) and myocardial infarction (5.2% vs 3.6%; AHR: 1.18; 95% CI [0.80-1.75]; P = 0.406) between groups. Conclusion: Diabetic patients had a comparable risk of MACE to nondiabetic patients at 1-year follow-up, despite having more comorbidities. in contrast to studies on PCI for de novo lesions, diabetes does not appear to increase the risk of TVR after ISR PCI at medium-term follow-up. Categories: CORONARY: Stents: Drug-Eluting

Volume

82

First Page

B246

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