Diabetes mellitus and Outcome after Successful Percutaneous Coronary Revascularization: The Mayo Clinic Experience 1979–1998

Abstract

Objective: To examine whether the outcome of patients after successful percutaneous coronary revascularization is influenced by diabetic status. Design: Retrospective analysis of the Mayo Clinic PTCA Registry. Materials and Methods: We analyzed the occurrence of all-cause death and death/myocardial infarction among diabetic (n = 2,155) and nondiabetic patients (n = 9,354) after successful percutaneous coronary revascularization at Mayo Clinic from October 1979 through December 1998. Results: Of the 11,509 patients who underwent percutaneous coronary revascularization during the study period, 2,155 were diabetic at the time of their index percutaneous coronary revascularization. The clinical success rate was similar for the two groups (≈87%). Among the patients with clinically successful interventions, the median (25th, 75th interquartiles) time of follow-up was 3.1 (1.1, 6.1) years for diabetic patients and 4.3 (2.0, 8.2) years for nondiabetic patients (p < 0.001). Diabetes mellitus was associated with increased adjusted risk (95% confidence interval) of death (1.73 [1.54, 1.94]) and death/infarction (1.62 [1.46, 1.79]). Conclusions: Although diabetic and nondiabetic patients had similar clinical success rates for percutaneous coronary revascularization, diabetic patients had significantly worse long-term outcomes.