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Multivessel drug-eluting stenting and impact of diabetes mellitus--a report from the EVENT registry.
Catheter Cardiovasc Interv. 2009 Jun 01; 73(7):874-80.CC

Abstract

OBJECTIVES

To compare clinical outcomes in patients with and without diabetes after multivessel percutaneous coronary intervention (PCI).

BACKGROUND

Diabetes is associated with significantly worse outcomes after multivessel PCI and coronary bypass surgery is recommended as the preferred option for these patients.

METHODS AND RESULTS

The Evaluation of Drug Eluting Stents and Ischemic Events registry is a multicenter evaluation of acute and 1 year outcomes in unselected patients undergoing PCI since approval of drug-eluting stents (DES). Major adverse cardiac events (MACE) were defined as all cause mortality, myocardial infarction, or repeat revascularization and rate was estimated by Kaplan-Meier method and compared using log-rank. The independent correlates of MACE were determined using Cox proportional hazards regression. Of 4,819 nonemergency native coronary DES procedures, 1,595 (33.1%) were in patients with diabetes and 722 (11.7%) involved >1 vessel. Of patients undergoing multivessel procedures, diabetes was present in 256 (35.5%). One year after multivessel PCI, MACE was similar for patients with or without diabetes (22.3% versus 21.2%, log-rank test P = 0.85). The independent correlates of 1 year MACE were female sex (Hazard ratio [HR], 1.58, 95% CI 1.14-2.20), ejection fraction (HR 0.74 per group [<25%, 26-35%, 36-50%, and >50%], 95%CI 0.59-0.94) and number of stents (HR 1.20 per stent, 95%CI 1.04-1.38) but not diabetes (HR 1.00, 95% CI 0.71-1.39).

CONCLUSIONS

Multivessel DES is performed commonly in patients with diabetes with outcomes at 1 year similar to patients without diabetes. Longer follow-up is required to more fully evaluate the safety and effectiveness of this strategy.

Authors+Show Affiliations

Harvard Clinical Research Institute, Boston, Massachusetts, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19180665

Citation

Novack, Victor, et al. "Multivessel Drug-eluting Stenting and Impact of Diabetes Mellitus--a Report From the EVENT Registry." Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, vol. 73, no. 7, 2009, pp. 874-80.
Novack V, Tsyvine D, Cohen DJ, et al. Multivessel drug-eluting stenting and impact of diabetes mellitus--a report from the EVENT registry. Catheter Cardiovasc Interv. 2009;73(7):874-80.
Novack, V., Tsyvine, D., Cohen, D. J., Pencina, M., Dubin, J., Dehghani, H., Kleiman, N. S., & Cutlip, D. E. (2009). Multivessel drug-eluting stenting and impact of diabetes mellitus--a report from the EVENT registry. Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, 73(7), 874-80. https://doi.org/10.1002/ccd.21925
Novack V, et al. Multivessel Drug-eluting Stenting and Impact of Diabetes Mellitus--a Report From the EVENT Registry. Catheter Cardiovasc Interv. 2009 Jun 1;73(7):874-80. PubMed PMID: 19180665.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multivessel drug-eluting stenting and impact of diabetes mellitus--a report from the EVENT registry. AU - Novack,Victor, AU - Tsyvine,Daniel, AU - Cohen,David J, AU - Pencina,Michael, AU - Dubin,Joseph, AU - Dehghani,Hossein, AU - Kleiman,Neal S, AU - Cutlip,Donald E, PY - 2009/1/31/entrez PY - 2009/1/31/pubmed PY - 2009/8/26/medline SP - 874 EP - 80 JF - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JO - Catheter Cardiovasc Interv VL - 73 IS - 7 N2 - OBJECTIVES: To compare clinical outcomes in patients with and without diabetes after multivessel percutaneous coronary intervention (PCI). BACKGROUND: Diabetes is associated with significantly worse outcomes after multivessel PCI and coronary bypass surgery is recommended as the preferred option for these patients. METHODS AND RESULTS: The Evaluation of Drug Eluting Stents and Ischemic Events registry is a multicenter evaluation of acute and 1 year outcomes in unselected patients undergoing PCI since approval of drug-eluting stents (DES). Major adverse cardiac events (MACE) were defined as all cause mortality, myocardial infarction, or repeat revascularization and rate was estimated by Kaplan-Meier method and compared using log-rank. The independent correlates of MACE were determined using Cox proportional hazards regression. Of 4,819 nonemergency native coronary DES procedures, 1,595 (33.1%) were in patients with diabetes and 722 (11.7%) involved >1 vessel. Of patients undergoing multivessel procedures, diabetes was present in 256 (35.5%). One year after multivessel PCI, MACE was similar for patients with or without diabetes (22.3% versus 21.2%, log-rank test P = 0.85). The independent correlates of 1 year MACE were female sex (Hazard ratio [HR], 1.58, 95% CI 1.14-2.20), ejection fraction (HR 0.74 per group [<25%, 26-35%, 36-50%, and >50%], 95%CI 0.59-0.94) and number of stents (HR 1.20 per stent, 95%CI 1.04-1.38) but not diabetes (HR 1.00, 95% CI 0.71-1.39). CONCLUSIONS: Multivessel DES is performed commonly in patients with diabetes with outcomes at 1 year similar to patients without diabetes. Longer follow-up is required to more fully evaluate the safety and effectiveness of this strategy. SN - 1522-726X UR - https://www.unboundmedicine.com/medline/citation/19180665/Multivessel_drug_eluting_stenting_and_impact_of_diabetes_mellitus__a_report_from_the_EVENT_registry_ L2 - https://doi.org/10.1002/ccd.21925 DB - PRIME DP - Unbound Medicine ER -