Outcome of Percutaneous Coronary Intervention with Drug Eluting Stent in Ischemic Heart Disease with Insulin Dependent and Noninsulin Dependent Diabetic Patients

Abstract

Background: Coronary artery diseases in diabetic patients are challenging because these patients represent about 25% of surgical coronary revascularization and percutaneous coronary intervention (PCI) procedures and have worse outcomes than patients without diabetes mellitus (DM) irrespective of the invasive management they receive. Patients and Methods: 53 insulin-dependent diabetic patients (ID) and non-insulin-dependent diabetic patients (NID) who underwent PCI with deployment of at least 1 drug-eluting stent (DES) in coronary arteries. Patients were divided into 2 groups: 18 ID patients & 35 NID patients. A comprehensive clinical work-up was planned one month and twelve months following the surgery, with angiographic follow-up scheduled 6-12 months thereafter. Results: Hyperlipidemia was more prevalent in the NID patients, while Coronary Artery Bypass Grafting (CABG) and multi-vessel disease were found more prevalent in the ID group than NID (p-value < 0.05). One-month follow-up showed no variations in the frequency of in-hospital mortality, Q-wave MI, or vascular sequelae. On the other hand, the rate of Target Lesions Revascularization (TRL), Non-Target Lesions Revascularization (NTLR), Nonfatal MI, and Cardiac death were high in ID patients. Conclusion: DES deployment, in comparison to coronary restenosis (ISR) following DES deployment, which remained considerably more prevalent in individuals with IDDM than in NIDDM patients, was observed to enhance angiographic and clinical results for IDDM and NIDDM patients. Long-term efficacy in those with IDDM was reduced due to an increased risk of revascularization.