Objective:To evaluate the long-term efficacy and safety of a novel type of cobalt-chromium sirolimus-eluting stent (CoCr-SES) in patients with coronary artery disease (CAD) complicated with diabetes mellitus (DM ) .Methods:A total of 1 045 Chinese patients with DM were enrolled into a prospective ,multicenter registered research and followed up for the incidence of death ,myocardial infarction (MI) ,blood circulation reconstruction and thrombosis (ST) among other events . The primary endpoint was a major adverse cardiovascular event (MACE) ,which was composed of cardiovascular death ,non-fatal myocardial infarction (MI) and target vessel revascularization (TVR) ,with a clinical follow-up of 3 years .Results:During the 3-year follow-up ,among 1 045 cases of coronary heart disease complicated with diabetes mellitus ,the rate of MACE was 10 .0% ,including 41 cases (3 .9% ) of cardiovascular death ,38 cases (3 .6% ) of non-fatal MI and 25 cases (2 .4% ) of TVR . The incidence of stent thrombosis (ST ) was 1 .1% in 3 years ,including 7 cases (0 .7% ) of early ST and 4 cases (0 .4% ) of advanced ST .Conclusions:The incidence of MACE and ST is low in patients with coronary heart disease complicated with diabetes at 3 years after implantation of CoCr-SES ,providing compelling evidence for the wide use of domestic CoCr-SES in patients with coronary heart disease complicated with diabetes .

Objective:To discuss the analysis on predictive factors of periprocedural myocardial inj ury (PMI)for type 2 diabetes patients with chronic total occlusion (CTO)from the pespective of clinical data,laboratory examination and imaging characteristics.Methods:Totally 134 cases with type II diabetes combined CTO in Zhongshan hospital of Fudan university heart intervention center database during January 2013 to December 2014 were selected.Results:In 134 cases with type 2 diabetes combined CTO,the average age was (62.12±9.018),in which male accounted for 81.34%(109/134).The incidence of PMI was 14.2% (19/134).Patients wre divided into PMI group (n= 19)and non-PMI group (n= 115)according to the occurrence of perioperative myocardial inj ury.The single factor analysis showed that the significant differences of ostial occlusion ,blunt stump,severe tortuosity,longer CTO length>20 mm,retrograde approach,Reverse CART approach,and J-CTO score between two groups.The Logistic multiple regression analysis showed that the Reverse CART approach (OR 7.580,P<0.05),occlusion length>20 mm (OR 3.642,P<0.05)were the independent predictor of PMI in type 2 diabetes patient with CTO.Conclusions:The Reverse CART technology,and occlusion length>20 mm are the independent predictor of PMI of type 2 diabetes mellitus combined CTO.To predict the special risk for perioperative myocardial injury patients, assessment of adverse cardiac events iscontributing to the choice of treatment strategy.

Chronic total occlusion(CTO)is the difficult point for percutaneous coronary intervention(PCI).Because of its special pathological basis,the patient's requirements are very high,the operation success rate is low,and the complication rate is high.Perioperative myocardial injury(PMI)is a complication of CTO-PCI.Compared with non-occlusive lesions,CTO-PCI can lead to PMI when it involves larger branch vessels and collateral vessels.This article reviews the causes,prevention and treatment progress of PMI associated with CTO-PCI.