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Short-Term Versus Long-Term Adverse Cardiovascular Outcomes Post Percutaneous Coronary Intervention in Patients with Insulin-Treated Type 2 Diabetes Mellitus: A Simple Meta-Analysis
INTRODUCTION: Type 2 diabetes mellitus (T2DM) is a major health issue, especially in patients with coexisting coronary artery disease (CAD). Patients with insulin-treated T2DM (ITDM) have worse outcomes than those with non-insulin-treated T2DM. Very few studies have compared short-term to long-term...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Healthcare
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612339/ https://www.ncbi.nlm.nih.gov/pubmed/31256352 http://dx.doi.org/10.1007/s13300-019-0656-9 |
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author | Lu, Hongtao Tang, Bing Zhou, Yanhua Xu, Chenhong Bundhun, Pravesh Kumar Tang, Zhangui Bao, Hong |
author_facet | Lu, Hongtao Tang, Bing Zhou, Yanhua Xu, Chenhong Bundhun, Pravesh Kumar Tang, Zhangui Bao, Hong |
author_sort | Lu, Hongtao |
collection | PubMed |
description | INTRODUCTION: Type 2 diabetes mellitus (T2DM) is a major health issue, especially in patients with coexisting coronary artery disease (CAD). Patients with insulin-treated T2DM (ITDM) have worse outcomes than those with non-insulin-treated T2DM. Very few studies have compared short-term to long-term adverse cardiovascular outcomes following percutaneous coronary intervention (PCI) in patients on insulin therapy. Therefore, in this meta-analysis, we systematically compared short-term to long-term adverse cardiovascular outcomes in a population of patients with ITDM following PCI. METHODS: We searched for English-language publications focusing on PCI in patients with ITDM using specific search terms/phrases. All the participants accepted for inclusion in this meta-analysis were treated with a drug-eluting stent. Post-intervention adverse cardiovascular outcomes observed during short-term and long-term follow-up periods were assessed and compared. Statistical analysis was carried out using the popular RevMan 5.3 software. Odd ratios (OR) with 95% confidence intervals (CI) were calculated. RESULTS: Six studies comprising 1568 participants with ITDM in total were included in this simple meta-analysis. Patient enrollment periods varied but enrollment occurred during the years 1993–2012. When a fixed-effects statistical model was used, post-PCI adverse cardiovascular outcomes—such as major adverse cardiac events (MACEs) (OR 3.33, 95% CI 2.64–4.21; P = 0.00001), all-cause mortality (OR 5.73, 95% CI 3.37–9.73; P = 0.00001), myocardial infarction (MI) (OR 1.47, 95% CI 1.05–2.07; P = 0.02), and repeated revascularization (OR 4.78, 95% CI 3.29–6.94; P = 0.00001)—were found to be significantly more likely during the long-term follow-up period. A similar result was observed with a random-effects statistical model. CONCLUSION: Adverse cardiovascular outcomes post PCI were significantly more likely during the long-term follow-up period than during the short-term follow-up period in these patients with T2DM on insulin therapy. This hypothesis requires confirmation via new comparative trials that consider short-term and long-term follow-up periods. |
format | Online Article Text |
id | pubmed-6612339 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Healthcare |
record_format | MEDLINE/PubMed |
spelling | pubmed-66123392019-07-23 Short-Term Versus Long-Term Adverse Cardiovascular Outcomes Post Percutaneous Coronary Intervention in Patients with Insulin-Treated Type 2 Diabetes Mellitus: A Simple Meta-Analysis Lu, Hongtao Tang, Bing Zhou, Yanhua Xu, Chenhong Bundhun, Pravesh Kumar Tang, Zhangui Bao, Hong Diabetes Ther Original Research INTRODUCTION: Type 2 diabetes mellitus (T2DM) is a major health issue, especially in patients with coexisting coronary artery disease (CAD). Patients with insulin-treated T2DM (ITDM) have worse outcomes than those with non-insulin-treated T2DM. Very few studies have compared short-term to long-term adverse cardiovascular outcomes following percutaneous coronary intervention (PCI) in patients on insulin therapy. Therefore, in this meta-analysis, we systematically compared short-term to long-term adverse cardiovascular outcomes in a population of patients with ITDM following PCI. METHODS: We searched for English-language publications focusing on PCI in patients with ITDM using specific search terms/phrases. All the participants accepted for inclusion in this meta-analysis were treated with a drug-eluting stent. Post-intervention adverse cardiovascular outcomes observed during short-term and long-term follow-up periods were assessed and compared. Statistical analysis was carried out using the popular RevMan 5.3 software. Odd ratios (OR) with 95% confidence intervals (CI) were calculated. RESULTS: Six studies comprising 1568 participants with ITDM in total were included in this simple meta-analysis. Patient enrollment periods varied but enrollment occurred during the years 1993–2012. When a fixed-effects statistical model was used, post-PCI adverse cardiovascular outcomes—such as major adverse cardiac events (MACEs) (OR 3.33, 95% CI 2.64–4.21; P = 0.00001), all-cause mortality (OR 5.73, 95% CI 3.37–9.73; P = 0.00001), myocardial infarction (MI) (OR 1.47, 95% CI 1.05–2.07; P = 0.02), and repeated revascularization (OR 4.78, 95% CI 3.29–6.94; P = 0.00001)—were found to be significantly more likely during the long-term follow-up period. A similar result was observed with a random-effects statistical model. CONCLUSION: Adverse cardiovascular outcomes post PCI were significantly more likely during the long-term follow-up period than during the short-term follow-up period in these patients with T2DM on insulin therapy. This hypothesis requires confirmation via new comparative trials that consider short-term and long-term follow-up periods. Springer Healthcare 2019-06-29 2019-08 /pmc/articles/PMC6612339/ /pubmed/31256352 http://dx.doi.org/10.1007/s13300-019-0656-9 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Research Lu, Hongtao Tang, Bing Zhou, Yanhua Xu, Chenhong Bundhun, Pravesh Kumar Tang, Zhangui Bao, Hong Short-Term Versus Long-Term Adverse Cardiovascular Outcomes Post Percutaneous Coronary Intervention in Patients with Insulin-Treated Type 2 Diabetes Mellitus: A Simple Meta-Analysis |
title | Short-Term Versus Long-Term Adverse Cardiovascular Outcomes Post Percutaneous Coronary Intervention in Patients with Insulin-Treated Type 2 Diabetes Mellitus: A Simple Meta-Analysis |
title_full | Short-Term Versus Long-Term Adverse Cardiovascular Outcomes Post Percutaneous Coronary Intervention in Patients with Insulin-Treated Type 2 Diabetes Mellitus: A Simple Meta-Analysis |
title_fullStr | Short-Term Versus Long-Term Adverse Cardiovascular Outcomes Post Percutaneous Coronary Intervention in Patients with Insulin-Treated Type 2 Diabetes Mellitus: A Simple Meta-Analysis |
title_full_unstemmed | Short-Term Versus Long-Term Adverse Cardiovascular Outcomes Post Percutaneous Coronary Intervention in Patients with Insulin-Treated Type 2 Diabetes Mellitus: A Simple Meta-Analysis |
title_short | Short-Term Versus Long-Term Adverse Cardiovascular Outcomes Post Percutaneous Coronary Intervention in Patients with Insulin-Treated Type 2 Diabetes Mellitus: A Simple Meta-Analysis |
title_sort | short-term versus long-term adverse cardiovascular outcomes post percutaneous coronary intervention in patients with insulin-treated type 2 diabetes mellitus: a simple meta-analysis |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612339/ https://www.ncbi.nlm.nih.gov/pubmed/31256352 http://dx.doi.org/10.1007/s13300-019-0656-9 |
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