Outcome of diabetic and non-diabetic patients undergoing successful coronary angioplasty with bare stent of chronic total occlusion.

Background: The prognosis of patients with diabetes mellitus and chronic coronary total occlusion (CTO) treated with percutaneous coronary angioplasty (PTCA) is poorly investigated.

Methods: To compare the long-term outcome of patients with CTO, with and without diabetes mellitus and undergoing successful PTCA with bare stent implantation performed in a single centre, 170 consecutive patients (mean age 62 +/- 10 years) with CTO aged > 1 month were analysed. Death, myocardial infarction, repeat angioplasty and coronary artery by-pass were considered as hard events in 167 patients with available long-term follow-up (mean 25 +/- 15 months).

Results: Vessel mean luminal diameter after the procedure and stent length were 2.5 +/- 0.4 mm and 21.9 +/- 9.4 mm, respectively. No differences were found in baseline clinical, angiographic and procedural variables between the groups, categorized on the basis of presence or absence of diabetes. There were 13 (27%) and 25 (21%) events in diabetic and non-diabetic groups, respectively (P = not significant). Multivariate analysis identified final mean luminal diameter (odds ratio = 4.7192, P = 0.0013) and stent length (odds ratio = 1.0655, P = 0.0003) but not diabetes (P = 0.78) as predictors of events at long-term follow-up.

Conclusions: Patients with and without diabetes undergoing CTO re-opening with stent implantation do not differ at long-term follow-up in terms of death, myocardial infarction and target lesion revascularizations. Final mean luminal diameter and stent length are significant predictors of events during long-term follow-up.