Long term outcomes of single versus multi-vessel coronary artery disease in patient with diabetes undergoing PCI

Abstract

Abstract Background Long-term outcomes of PCI in diabetics with single vessel disease (SVD) are less well known. We aimed to assess the long-term mortality of patients with diabetes with SVD compared to MVD undergoing PCI. Methods We included 7,506 consecutive patients with DM undergoing PCI from 34,784 patients in the Melbourne Interventional Group registry (2005–2018). Results 4,889 (65%) of DM had MVD. Compared to SVD, MVD were older (67±11 vs. 64±11 years), with higher rates of hypertension, insulin dependence, renal impairment, left ventricular ejection fraction <45% and cardiogenic shock (all p<0.001). Patients with MVD had significantly higher rates of stent thrombosis, unplanned CABG and major bleeding (all p<0.001). Unadjusted mortality rates in hospital, at 30 days and long-term (mean 5.4±3 years) were higher in MVD (4.1 vs 1.4%, 4.9% vs 1.9%, 26% vs 16.4%; all p<0.001). Cox proportional hazard modelling found MVD as an independent predictor of long-term mortality (HR 1.7, 95% CI 1.5–1.9, p<0.001). Long term mortality was similar for SVD diabetes and MVD non-diabetes (HR 1.29, 95% CI 1.13–1.48 vs 1.26, 95% 1.16–1.37), which was also evident on Kaplan-Meier curve. Conclusion DM with SVD undergoing PCI had a lower long-term mortality. However, the mortality beyond 5 years in SVD increases, mandating aggressive risk factor control and close clinical follow-up. Kaplan-Meier curve Funding Acknowledgement Type of funding source: None