Predictors and effect of repeat revascularization in elderly CHD patients with DM after coronary drug-eluting stent implantation
10.3969/j.issn.1009-0126.2018.03.004
- VernacularTitle:老年糖尿病患者冠状动脉支架术后再次血运重建的预测因素和影响
- Author:
Le WANG
1
;
Hongliang CONG
;
Yujie ZHOU
Author Information
1. 300051,天津市胸科医院心内科
- Keywords:
diabetes mellitus;
drug-eluting stents;
myocardial infarction;
atherosclerosis;
insulin;
cause of death
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2018;20(3):237-242
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the incidence and predictors of unplanned repeat revascularization (RR) in CHD patients with DM within 2 years after coronary drug-eluting stent (DES) implantation.Methods A total of 2764 CHD patients with DM who underwent successful DES were divided into RR group (n=383) and non-RR group (n=2381).The effect of RR on all-cause mortality and myocardial infarction (MI) was analyzed by Cox regression analysis.Results Unplanned RR was detected in 383 patients (13.9％) within 2 years after DES.The rate of insulin therapy for DM was higher and the duration of DM was longer in RR group than in non-RR group (P＜0.05,P＜0.01).Multivariate Cox regression analysis showed that insulin therapy for DM,history of coronary artery bypass graft,serum HbAlc and LDL-C level,multivessel PCI and no use of statins during the follow-up period were the independent predictors of RR.RR was related with MI (adjusted HR=3.967,95％CI:1.284-6.254,P=0.017) but not related with all-cause mortality (adjusted HR=6.134,95％CI:0.435-26.224,P=0.154).Conclusion The severity of disease,complex coronary artery procedures and insufficient drug therapy are the risk factors for RR,and RR is related with ischemic cardiovascular events.
