[Impact of diabetes on clinical outcomes following multivessel percutaneous interventions].

Objective: To compare the rates of mortality, myocardial infarction (MI), repeat revascularization and stent thrombosis after percutaneous coronary intervention (PCI) with implantation of stents for diabetics versus nondiabetics with multivessel disease to evaluate the impact of diabetes on long-term clinical outcomes.

Methods: We consecutively recruited a total of 1985 patients with multivessel disease at our institution from July 2003 to December 2005. And they were divided into two groups of diabetes (n = 587) or non-diabetes (n = 1398). The primary endpoint was all-cause mortality at 24 months.

Results: After adjusting with Logistic regression, the risk of mortality in the diabetics was significantly higher than that in the nondiabetics (4.4% vs 2.0%, hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.02 to 3.67, P = 0.021). Similar outcome was also found in the adjusted risk of cardiac mortality (2.7% vs 1.1%, HR = 2.04, 95%CI 1.12 to 3.89, P = 0.032) at 24 months, although the adjusted risk of nonfatal MI and repeat revascularization was similar. However, diabetes significantly increased the risk of stent thrombosis. The major adverse cardiac event (MACE) rate was also lower in the nondiabetics (15.8% vs 11.9%, HR = 1.52, 95%CI 1.12 to 1.89, P = 0.043).

Conclusion: In patients with multivessel disease, diabetes is correlated with increase risks of mortality, stent thrombosis and MACE at long-term follow-up compared with non-diabetes.