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Percutaneous coronary intervention for left main stem disease: Impact of diabetes mellitus on mortality

Lookup NU author(s): Dr Bilal Bawamia, Dr Mohaned Egred, Dr Matthew Jackson, Dr David AustinORCiD, Professor Azfar ZamanORCiD

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Abstract

© 2020 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals, Inc.Objectives: We assessed the impact of diabetes mellitus (DM) on mortality after percutaneous coronary intervention (PCI) for left main stem (LMS) disease. Second, we compared mortality outcomes between non-insulin treated (NITDM) and insulin treated diabetes (ITDM) in different clinical settings. Background: There is a paucity of “real world” outcomes data in diabetic patients undergoing LMS PCI. Methods: We undertook a retrospective analysis of consecutive patients undergoing unprotected LMS PCI at 2 high volume tertiary centers. Diabetic status and clinical setting for PCI were recorded. The primary outcome measure was all-cause 30-day and long-term mortality (up to 36 months) post index PCI. Results: Between 2003 and 2017, 2,675 patients undergoing index LMS PCI were analyzed. Of those, 77.1% were non-DM, 15.8% NITDM, and 7.1% ITDM. Overall, DM status was not associated with higher 30-day mortality (OR 1.39, 95% CI 0.89–2.16, p =.15). During a median follow-up of 36 months, there was a borderline statistical association of DM with long-term mortality in all PCI settings (HR 1.31, 95% CI 1.00–1.71, p =.05). Compared to non-DM, ITDM but not NITDM was associated with short- and long-term mortality in all clinical presentations. Conclusions: Overall, DM did not impact on 30-day mortality and had only a borderline statistical association with long-term mortality. It did not have an influence on mortality in non-emergency LMS PCI. The impact of DM on mortality outcomes following LMS PCI was only significant in the insulin treated patients.

Publication metadata

Author(s): Bawamia BR, Egred M, Jackson M, Purcell I, Austin D, Zaman AG

Publication type: Article

Publication status: Published

Journal: Catheterization and Cardiovascular Interventions

Year: 2020

Volume: 96

Issue: 4

Pages: E416-E422

Print publication date: 01/10/2020

Online publication date: 05/03/2020

Acceptance date: 14/02/2020

Date deposited: 02/04/2020

ISSN (print): 1522-1946

ISSN (electronic): 1522-726X

Publisher: John Wiley and Sons Inc.

URL: https://doi.org/10.1002/ccd.28818

DOI: 10.1002/ccd.28818

PubMed id: 32134178

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