Impact of Diabetes Mellitus on Long-term Prognosis of Patients After Implantation of Biodegradable Polymer Drug Eluting Stent or Excel Stent
10.3969/j.issn.1000-3614.2018.06.005
- VernacularTitle:糖尿病对于冠心病患者置入生物可降解聚合物涂层药物洗脱支架长期预后的影响
- Author:
Juan WANG
1
;
Shu-Bin QIAO
;
Chang-Dong GUAN
;
Feng-Huan HU
;
Wei-Xian YANG
;
Jian-Song YUAN
;
Chao GUO
;
Xin DUAN
;
Run-Lin GAO
;
Bo XU
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 冠心病诊治中心
- Keywords:
Diabetes mellitus;
Percutaneous coronary intervention;
Coronary artery disease;
Target lesion failure
- From:
Chinese Circulation Journal
2018;33(6):539-544
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To evaluate the impact of diabetes mellitus on prognosis of coronary artery disease patients after implantation of the novel biodegradable polymer drug eluting stents. Methods:PANDA Ⅲ was a perspective, multi-center, "all-comer", randomized controlled trial. Between Dec. 2013 and Sep. 2014, 2 348 patients from 46 centers were enrolled. All the patients underwent percutaneous coronary intervention, among them 1 174 patients implanted with BuMA stent and 1 174 patients implanted with Excel stent. Mean age was 61.2 ±10.6, 1 658 patients (70.6%) were male, 570 (24.2%) patients presented with diabetes mellitus (DM) and 1 778 (75.7%) without DM. Patients were divided into DM and non-DM groups. Primary endpoint was target lesion failure (TLF), including cardiac death, target vessel myocardial infarction and ischemia driven target lesion revascularization. Secondary endpoints included stent thrombosis and major adverse cardiac events (MACE), defined as a composite of death, myocardial infarction and any revascularization. Results:A total of 558 (97.9%) and 1 704 (95.8%) patients completed 2-year follow-up in DM and non-DM groups. Incidence of TLF in the DM and non-DM group was 8.24% vs. 6.81%, P=0.25, and cardiac death rate was significantly higher in the DM group compared with non-DM group:2.87% vs. 1.12%, P=0.004. Incidence of MACE was similar between two group:13.98% vs. 11.38, P=0.10. Myocardial infarction and any revascularization events were numericallyhigher in the DM group compared with non-DM group, but without statistical significance:5.73% vs. 5.11%, P=0.56; 6.45% vs. 5.46%, P=0.38, respectively. Incidence of all-cause death was significantly higher in the DM group compared with non-DM group:4.30% vs. 2.46%, P=0.03. The results were similar after propensity match analysis. Multivariable analysis showed that DM and baseline SYNTAX score were independent factors for 2-year cardiac death. Conclusions:Two-year incidence of TLF is similar in coronary artery disease patients with or without DM post implantation of biodegradable polymer drug eluting stent or Excel stent, however, the rate of death especially cardiac death is significantly higher in the DM group than in the non-DM group.
