Late clinical outcome of coronary stenting in diabetic patients

Introduction. The Influence of diabetes mellitus in the tate outcome of cor onary stenting remains controversial. Aim. The aim of this study was to determine the late clinical outcome of di abetics in comparison with non diabetics and to establish whether there are subgroups of diabetic patients with a greater need for target lesion revas cularization. Methods. Two hundred sixteen consecutive patients (74 diabetics; 95 stents in 90 lesions and 142 non diabetics) who had successfully undergone coronar y stenting were included in the study and followed over 17.6 +/- 10 months. The clinical events evaluated were target lesion revascularization, death and acute myocardial infarction. independent predictive variables of target lesion revascularization were studied in both groups of patients. Results. The diabetic patients presented greater cardiovascular mortality ( 6.7% vs 1.4%; p = 0.02) but the incidence of infarction was similar in the two groups (2.7% vs 3.5%; p = 0.6). The accumulated rate of target lesion r evascularization at two years was 18,2% in diabetics vs 13.3% in non diabet ics (p = 0.09), respectively. The presence of three vessel disease (p = 0.0 14), history of arterial hypertension (p = 0.011) and residual stenosis > 0 % (p = 0.005) were specific predictive factors of target lesion revasculari zation for diabetic patients and together with vessel diameter < 3 mm (p < 0.001) subgroups of diabetics were independently selected with a significan tly greater incidence of target lesion revascularization than the non diabe tic patients. Conclusions. Following coronary stenting, diabetic patients show a greater cardiovascular mortality than non diabetics, but only some subgroups of dia betics (small vessels extensive coronary disease, associated arterial hyper tension, residual stenosis) show a significantly greater risk of target les ion revascularization.