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Impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention

BACKGROUND: The prognosis of elderly patients with chronic total occlusion (CTO) and diabetes mellitus (DM) treated with percutaneous coronary intervention (PCI) is not known. OBJECTIVE: To investigate the effect of diabetes on long-term follow-up of CTO after PCI in elderly patients. METHODS: A tot...

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Autores principales: Liu, Wei, Wagatsuma, Kenji, Nii, Hideo, Toda, Mikihito, Amano, Hideo, Uchida, Yasuto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Science Press 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3627706/
https://www.ncbi.nlm.nih.gov/pubmed/23610569
http://dx.doi.org/10.3969/j.issn.1671-5411.2013.01.004
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author Liu, Wei
Wagatsuma, Kenji
Nii, Hideo
Toda, Mikihito
Amano, Hideo
Uchida, Yasuto
author_facet Liu, Wei
Wagatsuma, Kenji
Nii, Hideo
Toda, Mikihito
Amano, Hideo
Uchida, Yasuto
author_sort Liu, Wei
collection PubMed
description BACKGROUND: The prognosis of elderly patients with chronic total occlusion (CTO) and diabetes mellitus (DM) treated with percutaneous coronary intervention (PCI) is not known. OBJECTIVE: To investigate the effect of diabetes on long-term follow-up of CTO after PCI in elderly patients. METHODS: A total of 153 elderly patients (age > 65 years old) with CTO lesions which were successfully treated with PCI were enrolled. Fifty one patients with diabetes and 102 without diabetes were compared for long-term outcomes (mean follow up: 36 ± 12 months). Major adverse cardiac events (MACE) which include death, myocardial infarction or target lesion revascularization (TLR) were considered as a combined endpoint. RESULTS: The combined endpoint occurred in 29.4% of diabetes patients, and 11.3% of the patients without diabetes (P < 0.05). The Cox proportional hazards model identified: drug eluting stent (DES) or bare metal stent (BMS) (HR: 0.13, 95% confidence interval (95% CI): 0.03–0.62, P = 0.004), DM (HR: 6.69, 95% CI: 1.62–15.81, P = 0.01) and final minimal lumen diameter (MLD) (HR: 0.37, 95% CI: 0.13–0.90, P = 0.03 ) as independent predictors of MACE, DM with renal impairment (HR: 6.64, 95% CI: 1.32–33.36, P = 0.02), HBA1C on admission (HR: 1.79, 95% CI: 1.09–2.94, P = 0.02), as independent predictors of MACE at long term follow-up. CONCLUSIONS: The study demonstrates that DM is a predictive factor for MACE in elderly CTO patients treated with PCI, type of stent, final minimal lumen diameter and DM with renal impairment, and HBA1C level on admission are predictors of MACE.
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spelling pubmed-36277062013-04-22 Impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention Liu, Wei Wagatsuma, Kenji Nii, Hideo Toda, Mikihito Amano, Hideo Uchida, Yasuto J Geriatr Cardiol Research Article BACKGROUND: The prognosis of elderly patients with chronic total occlusion (CTO) and diabetes mellitus (DM) treated with percutaneous coronary intervention (PCI) is not known. OBJECTIVE: To investigate the effect of diabetes on long-term follow-up of CTO after PCI in elderly patients. METHODS: A total of 153 elderly patients (age > 65 years old) with CTO lesions which were successfully treated with PCI were enrolled. Fifty one patients with diabetes and 102 without diabetes were compared for long-term outcomes (mean follow up: 36 ± 12 months). Major adverse cardiac events (MACE) which include death, myocardial infarction or target lesion revascularization (TLR) were considered as a combined endpoint. RESULTS: The combined endpoint occurred in 29.4% of diabetes patients, and 11.3% of the patients without diabetes (P < 0.05). The Cox proportional hazards model identified: drug eluting stent (DES) or bare metal stent (BMS) (HR: 0.13, 95% confidence interval (95% CI): 0.03–0.62, P = 0.004), DM (HR: 6.69, 95% CI: 1.62–15.81, P = 0.01) and final minimal lumen diameter (MLD) (HR: 0.37, 95% CI: 0.13–0.90, P = 0.03 ) as independent predictors of MACE, DM with renal impairment (HR: 6.64, 95% CI: 1.32–33.36, P = 0.02), HBA1C on admission (HR: 1.79, 95% CI: 1.09–2.94, P = 0.02), as independent predictors of MACE at long term follow-up. CONCLUSIONS: The study demonstrates that DM is a predictive factor for MACE in elderly CTO patients treated with PCI, type of stent, final minimal lumen diameter and DM with renal impairment, and HBA1C level on admission are predictors of MACE. Science Press 2013-03 /pmc/articles/PMC3627706/ /pubmed/23610569 http://dx.doi.org/10.3969/j.issn.1671-5411.2013.01.004 Text en Institute of Geriatric Cardiology http://creativecommons.org/licenses/by-nc-sa/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License, which allows readers to alter, transform, or build upon the article and then distribute the resulting work under the same or similar license to this one. The work must be attributed back to the original author and commercial use is not permitted without specific permission.
spellingShingle Research Article
Liu, Wei
Wagatsuma, Kenji
Nii, Hideo
Toda, Mikihito
Amano, Hideo
Uchida, Yasuto
Impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention
title Impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention
title_full Impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention
title_fullStr Impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention
title_full_unstemmed Impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention
title_short Impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention
title_sort impact of diabetes on long term follow-up of elderly patients with chronic total occlusion post percutaneous coronary intervention
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3627706/
https://www.ncbi.nlm.nih.gov/pubmed/23610569
http://dx.doi.org/10.3969/j.issn.1671-5411.2013.01.004
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