Coronary stenting in diabetics: Immediate and mid-term clinical outcome

Balloon angioplasty in diabetics is associated with acceptable immediate re sults but with high rates of restenosis, target vessel revascularization, a nd late mortality. The impact of coronary stenting on the outcome of these patients remains controversial. We reported the immediate and mid-term clin ical outcome of 272 consecutive diabetic patients, representing 12.5% of th e population undergoing coronary stenting between May 1995 and April 1997. Diabetes mellitus was insulin-requiring in 58 patients and non-insulin-requ iring in 214. Stenting performed on large vessels (mean diameter greater th an or equal to 3 mm) was successful in 99.2% of nondiabetic patients and in all cases in diabetics. During in-hospital stay, the complications rate, i ncluding mortality, nonfatal myocardial infarction, emergency coronary bypa ss surgery, and stent subacute thrombosis, was similar in nondiabetic patie nts, insulin-requiring, and non-insulin-requiring diabetics (2.55%, 0%, and 2.0%, respectively). No complication occurred in the insulin-requiring gro up. One patient (0.5%) died from myocardial infarction and another (0.5%) p resented a nonfatal myocardial infarction (subacute stent thrombosis) in th e non-insulin-requiring group. The clinical follow-up (mean length 13 +/- 8 months) was obtained in 93% and 97% of the insulin-requiring and non-insul in-requiring diabetics, respectively, Overall mortality was significantly h igher in insulin-requiring patients (9.3% vs. 2.4%), Nonfatal myocardial in farction and target lesion revascularization rates were similar in the two groups (0% vs. 0.5% and 8.2% vs. 10.5%). These results suggest that coronar y stenting in diabetics could be performed with acceptable immediate and mi d-term results. Cathet. Cardiovasc. Intervent. 47:279-284, 1999. (C) 1999 W iley-Liss, Inc.