In-stent restenosis of drug-eluting stents in patients with diabetes mellitus: Clinical presentation, angiographic features, and outcomes
Objective: Diabetes mellitus (DM) is a risk factor for developing in-stent restenosis (ISR) following percutaneous coronary intervention (PCI). This study aimed to examine the presentation and outcomes of drug-eluting stent (DES) ISR in diabetics. Methods: This retrospective study included consecuti...
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doaj-051621de3a94421a9b78f5bb00cbb9f72021-01-19T08:06:19ZengKARE PublishingAnatolian Journal of Cardiology2149-22632019-12-01231283410.14744/AnatolJCardiol.2019.72916AJC-72916In-stent restenosis of drug-eluting stents in patients with diabetes mellitus: Clinical presentation, angiographic features, and outcomesGanesh Paramasivam0Tom Devasia1Ashwal Jayaram2Abdul Razak U.K3M. Sudhakar Rao4Rajesh Vijayvergiya5Krishnananda Nayak6Department of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal; Karnataka-IndiaDepartment of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal; Karnataka-IndiaDepartment of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal; Karnataka-IndiaDepartment of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal; Karnataka-IndiaDepartment of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal; Karnataka-IndiaDepartment of Cardiology, Postgraduate Institute of Medical Education and Research (PGIMER); Chandigarh-IndiaDepartment of Cardiovascular Technology, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal; Karnataka-IndiaObjective: Diabetes mellitus (DM) is a risk factor for developing in-stent restenosis (ISR) following percutaneous coronary intervention (PCI). This study aimed to examine the presentation and outcomes of drug-eluting stent (DES) ISR in diabetics. Methods: This retrospective study included consecutive patients with clinical DES-ISR, who were hospitalized between January 2013 and December 2017 and who were grouped based on the presence or absence of DM. Clinical, angiographic features and 1-year outcomes [composite of death, myocardial infarction (MI), and repeat-target lesion revascularization] were compared. Results: Baseline characteristics of the DM group (n=109) were comparable to the non-DM group (n=82), except for the higher prevalence of hypertension and dyslipidemia in the former (60.6% vs. 46.3%, p=0.050; 74.4% vs. 57.8%, p=0.034, respectively). Clinical presentation was similar in both groups [acute coronary syndrome (ACS): 62.4% vs. 61%, p=0.843; MI: 34.9% vs. 34.1%, p=0.918). Diabetics had a higher prevalence of stent-edge restenosis (20.3% vs. 9.2%, p=0.019). The treatment strategy was similar in both groups with 52.3% in the DM group and 57.3% in the non-DM group undergoing PCI (p=0.513). One-year outcomes of the DM group were not different from those of the non-DM group (14.7% vs. 17.1%, p=0.683). Age [hazard ratio (HR), 1.05; 95% confidence interval (CI), 1.01–1.10; p=0.017], MI presentation (HR, 2.34; 95% CI, 1.14–4.80; p=0.020), and chronic kidney disease (CKD: HR, 2.82; 95% CI, 1.21–6.58; p=0.016) were predictors of poor outcomes. Conclusion: Stent-edge restenosis is more common in diabetics. Clinical presentation and 1-year outcomes following DES-ISR are similar in diabetics and non-diabetics. Age, MI presentation, CKD, and not DM were predictors of poor outcomes following DES-ISR.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-72916coronary restenosisdrug-eluting stentdiabetes mellitusin-stent restenosispercutaneous coronary interventionpercutaneous transluminal coronary angioplasty |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ganesh Paramasivam Tom Devasia Ashwal Jayaram Abdul Razak U.K M. Sudhakar Rao Rajesh Vijayvergiya Krishnananda Nayak |
spellingShingle |
Ganesh Paramasivam Tom Devasia Ashwal Jayaram Abdul Razak U.K M. Sudhakar Rao Rajesh Vijayvergiya Krishnananda Nayak In-stent restenosis of drug-eluting stents in patients with diabetes mellitus: Clinical presentation, angiographic features, and outcomes Anatolian Journal of Cardiology coronary restenosis drug-eluting stent diabetes mellitus in-stent restenosis percutaneous coronary intervention percutaneous transluminal coronary angioplasty |
author_facet |
Ganesh Paramasivam Tom Devasia Ashwal Jayaram Abdul Razak U.K M. Sudhakar Rao Rajesh Vijayvergiya Krishnananda Nayak |
author_sort |
Ganesh Paramasivam |
title |
In-stent restenosis of drug-eluting stents in patients with diabetes mellitus: Clinical presentation, angiographic features, and outcomes |
title_short |
In-stent restenosis of drug-eluting stents in patients with diabetes mellitus: Clinical presentation, angiographic features, and outcomes |
title_full |
In-stent restenosis of drug-eluting stents in patients with diabetes mellitus: Clinical presentation, angiographic features, and outcomes |
title_fullStr |
In-stent restenosis of drug-eluting stents in patients with diabetes mellitus: Clinical presentation, angiographic features, and outcomes |
title_full_unstemmed |
In-stent restenosis of drug-eluting stents in patients with diabetes mellitus: Clinical presentation, angiographic features, and outcomes |
title_sort |
in-stent restenosis of drug-eluting stents in patients with diabetes mellitus: clinical presentation, angiographic features, and outcomes |
publisher |
KARE Publishing |
series |
Anatolian Journal of Cardiology |
issn |
2149-2263 |
publishDate |
2019-12-01 |
description |
Objective: Diabetes mellitus (DM) is a risk factor for developing in-stent restenosis (ISR) following percutaneous coronary intervention (PCI). This study aimed to examine the presentation and outcomes of drug-eluting stent (DES) ISR in diabetics.
Methods: This retrospective study included consecutive patients with clinical DES-ISR, who were hospitalized between January 2013 and December 2017 and who were grouped based on the presence or absence of DM. Clinical, angiographic features and 1-year outcomes [composite of death, myocardial infarction (MI), and repeat-target lesion revascularization] were compared.
Results: Baseline characteristics of the DM group (n=109) were comparable to the non-DM group (n=82), except for the higher prevalence of hypertension and dyslipidemia in the former (60.6% vs. 46.3%, p=0.050; 74.4% vs. 57.8%, p=0.034, respectively). Clinical presentation was similar in both groups [acute coronary syndrome (ACS): 62.4% vs. 61%, p=0.843; MI: 34.9% vs. 34.1%, p=0.918). Diabetics had a higher prevalence of stent-edge restenosis (20.3% vs. 9.2%, p=0.019). The treatment strategy was similar in both groups with 52.3% in the DM group and 57.3% in the non-DM group undergoing PCI (p=0.513). One-year outcomes of the DM group were not different from those of the non-DM group (14.7% vs. 17.1%, p=0.683). Age [hazard ratio (HR), 1.05; 95% confidence interval (CI), 1.01–1.10; p=0.017], MI presentation (HR, 2.34; 95% CI, 1.14–4.80; p=0.020), and chronic kidney disease (CKD: HR, 2.82; 95% CI, 1.21–6.58; p=0.016) were predictors of poor outcomes.
Conclusion: Stent-edge restenosis is more common in diabetics. Clinical presentation and 1-year outcomes following DES-ISR are similar in diabetics and non-diabetics. Age, MI presentation, CKD, and not DM were predictors of poor outcomes following DES-ISR. |
topic |
coronary restenosis drug-eluting stent diabetes mellitus in-stent restenosis percutaneous coronary intervention percutaneous transluminal coronary angioplasty |
url |
https://jag.journalagent.com/z4/download_fulltext.asp?pdir=anatoljcardiol&un=AJC-72916 |
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