Comparison of Post PCI TIMI Flow Between Diabetic and Non-Diabetic Individuals

Abstract

Background: Cardiovascular diseases remain the leading cause of morbidity and mortality globally, with diabetes significantly exacerbating the incidence and severity of coronary artery disease. Diabetic patients experience altered coronary blood flow dynamics, which can impact the efficacy of therapeutic interventions like percutaneous coronary intervention (PCI). Objective: This study aims to compare the post-PCI Thrombolysis in Myocardial Infarction (TIMI) flow grades between diabetic and non-diabetic patients to assess the impact of diabetes on the short-term outcomes of coronary revascularization. Methods: A retrospective observational study was conducted at the National Institute of Cardiovascular Diseases in Karachi, involving 3,000 patients who underwent primary PCI between January 2018 and December 2020. Patients were categorized into diabetic (1,500) and non-diabetic (1,500) groups. Data collected included demographics, coronary artery risk factors, TIMI flow grades before and after PCI, and the use of GPIIb/IIIa inhibitors. Statistical analysis was performed using SPSS version 25, employing chi-square tests, t-tests, and Mann-Whitney U tests for comparative analysis, with a p-value of <0.05 considered statistically significant. Results: The study found significant differences in postoperative TIMI3 flow rates, with non-diabetic patients achieving a higher rate of TIMI3 (59.4%) compared to diabetic patients (58.1%). The use of GPIIb/IIIa inhibitors was higher in diabetic patients (34.7%) than in non-diabetic patients (1.8%). Additionally, diabetic patients showed a higher incidence of multi-vessel disease and more severe lesion profiles, including higher rates of triple branch lesions (45.9% vs. 39.9%) and left main lesions (53% vs. 43.9%). Conclusion: Diabetic patients exhibit worse post-PCI TIMI flow grades and more complex coronary lesions compared to non-diabetic patients, suggesting that diabetes adversely affects the outcomes of coronary revascularization. These findings underscore the need for tailored therapeutic approaches to improve PCI outcomes in diabetic patients.