Objective : Diabetic patients (pts) have a greater potential of cardiac events and restenosis following balloon angioplasty- The impact of diabetes mellitus (DM) ,especially multivessel disease ,on in stent restenosis...
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Objective : Diabetic patients (pts) have a greater potential of cardiac events and restenosis following balloon angioplasty- The impact of diabetes mellitus (DM) ,especially multivessel disease ,on in stent restenosis an issue in debat- Methods : We studied 126 (non insulin dependent DM , NIDDM, n = 20 , Nondiabetics , n = 106) consecutive pts (144 lesions) with coronary heart disease (CHD) treated with percutaneous transluminal coronary angioplasty (PTCA) , NIR PRIMOSTENT, AVE MICRO STENTimplantation using conventional coronary angiographic technique- Quantitative angiographic results showed : Lesion Length ( m m) 12-00 ±3-42 , 10-2 ±4-54 , reference inner diameter of the vessel before stenting (m m) 2-80 ±0-25 ,2-95 ±0-42 , minimalinner diameter before stenting ( m m) 0-83 ±0-46 , 1-20 ±0-48 , minimalinner diameter after stenting ( m m ) 2-60 ±0-34 , 2-94 ±0-62 , Prestenting stenosis ( % ) 86 ±12 , 75 ±15 , Poststenting stenosis ( % ) 10 ±2 ,5 ±3 ,in NIDDMand non diabetic pts ,respectively- Proceduralsuccess ,acute and late cardiac events ,clinical outcome were compared according to the diabetic status- Results : No in hospital death was occurred in this study- During follow up (4 ～36 months) , major cardiac events occurred in 4 pts (20 % ) in NIDDM,4 pts (3-8 % ) in nondiabetics- Target lesion revascularization (TLR) was performed in 10 pts (50 % ) in NIDDM- PTCA stent wasperformed in 5 pts and coronary arthery bypass graft (CABG) in another 5 pts with three vessel disease- TLRin 5 pts (4-7 % ) in nondiabetics , including 4 PTCA stent and 1 CABG- Late cardiac enent free survival (death , myocardial infarction , TLR was excluded) was significantly lower in NIDDM (10 pts ,50 % ) compared with nondiabetic pts (99 pts ,93 % )- Conclusion :In a series of pts treated by elective PTCAstentimplantation , NIDDM pts were at higher risk of heart complications and subsequent TLR, as a result ,had a significantly lower cardiac event free survival rate- CABG was the best chsic
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