In-Hospital Outcome of Patients with Diabetes Mellitus after CTO Recanalization with Third-Generation Drug-Eluting Stents

Jan-Erik Guelker; Lars Bansemir; Rainer Ott; Thomas Rock; Rosemarie Guelker; MSc .; Dong-In Shin; Heinrich Klues; Alexander Bufe

doi:10.18502/jthc.v14i2.1369

Jan-Erik Guelker
Lars Bansemir
Rainer Ott
Thomas Rock
Rosemarie Guelker
MSc .
Dong-In Shin
Heinrich Klues
Alexander Bufe

DOI: https://doi.org/10.18502/jthc.v14i2.1369

Keywords: Coronary artery disease; Coronary occlusion; Diabetes mellitus; Treatment outcome

Abstract

Background: Percutaneous coronary intervention (PCI) of total chronic coronary occlusions (CTOs) still remains a major challenge in interventional cardiology. There is little knowledge in the literature about differences in CTO-PCI between diabetic and nondiabetic patients in the era of third-generation drug-eluting stents (DESs). In this study, we analyzed the impact of diabetes mellitus (DM) on procedural characteristics, complications, and acute outcomes in a cohort of 440 patients.

Methods: Between 2012 and 2016, we recruited 440 consecutive patients, 116 of them with DM. All the patients underwent PCI for at least 1 CTO. Antegrade and retrograde CTO recanalization techniques were applied. Only third-generation DESs were used. We used t-tests and the Pearson chi-quadrat test to test the significant differences in the variables between the 2 groups.

Results: The patients with DM were older than the nondiabetics (64.5 y vs. 61.1 y; P=0.003), and they suffered more frequently from a chronic kidney disease (7.1% vs. 2.4%; P=0.001). The nondiabetics less frequently had arterial hypertension (75.3% vs. 89.7%; P=0.001); however, they more often had a family liability for CAD (32.1% vs. 22.4%; P=0.050) and had a higher left ventricular ejection fraction (59.2% vs. 56.7%; P=0.011). The success rate was 85.2% in the patients without DM and 81.2% in the patients with DM (P=0.403). The existence of DM had no impact on the procedural success and complication rates.

Conclusion: Our study on 440 patients shows that diabetics and nondiabetics have similar success and complication rates after the recanalization of CTOs using third-generation DESs. It is a feasible and safe procedure and can be recommended as an alternative treatment.

J Teh Univ Heart Ctr 2019;14(2):47-52

This paper should be cited as: Guelker J. E, Bansemir L, Ott R, Rock T, Guelker R, Shin D. I, Klues H. G, Bufe A. In-hospital Outcome of Patients with Diabetes Mellitus after CTO Recanalization with Third-Generation Drug-Eluting Stents. J Teh Univ Heart Ctr 2019;14(2):47-52.