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BACKGROUND

Impact of Diabetes Mellitus on Early and Long-term Results of Percutaneous Drug-eluting Stent Implantation for Unprotected Left Main Coronary Disease.

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BACKGROUND

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  1. Impact of Diabetes Mellitus on Early and Long-term Results of Percutaneous Drug-eluting Stent Implantation for Unprotected Left Main Coronary Disease Paolo Garrone, Dario Sillano, Primiano Lombardi, Claudio Moretti, Filippo Sciuto, Pierluigi Omedè, Giuseppe Biondi-Zoccai, Gian Paolo Trevi, Imad Sheiban Division of Cardiology, University of Turin, Italy

  2. BACKGROUND • Percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation is increasingly used for unprotected left main disease (ULM) • Drug-eluting stent implantation favorably influences outcome in diabetic patientswith non-ULM • There are no data on the clinical results of DES for ULM in diabetic patients

  3. AIM OF THE STUDY We aimed to appraise the outcomes of diabetics with unprotected left main disease (ULM) treated with drug-eluting stents (DES)

  4. METHODS We abstracted baseline, procedural and follow-up data on all patients • undergoing PCI for ULM disease at our Institution • treated with DES • since 2002 and • identified 3 groups according to their diabetic status

  5. END-POINT We evaluate the rate of major adverse cardiac events (MACE) defined as: • cardiac death, • myocardial infarction, • or target vessel revascularization Secondary end-points were individual MACE components and stent thrombosis (according to ARC)

  6. RESULTS

  7. RESULTS

  8. RESULTS • In-hospital adverse events were uncommon and not significantly different across groups: 1/25 (4%), 2/30 (7%), and 8/130 (6%) (p=0.86). • After a median follow-up of 23.1 months, MACE had occurred in similar rates across groups...

  9. RESULTS

  10. RESULTS

  11. RESULTS

  12. RESULTS

  13. MACE-free survival Non-diabetics NIDD IDD P=0.88 Time (days) MACE-free survival

  14. CONCLUSION • Drug-eluting stents provide favorable early and long-term results in both diabetics and non-diabetic patients undergoing PCI for ULM. • Given the possible increased risk of thrombosis among insulin-dependent-diabetics, these patients should probably be treated with dual antiplatelet therapy for a more prolonged time.

  15. For further slides on these topics please feel free to visit the metcardio.org website:http://www.metcardio.org/slides.html

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