Restenosis after Percutaneous Transluminal Coronary Angioplasty in Patients with Non-Insulin-Dependent Diabetes Mellitus (NIDDM)

Abstract

The effect of glycemic control on the incidence of restenosis after percutaneous transluminal coronary angioplasty (PTCA) in non-insulin-dependent diabetes mellitus (NIDDM) has not been well analysed. Out of 1282 consecutive patients who had undergone elective and successful PTCA over 8 years, 86 known to have NIDDM and 117 non-diabetic cases were analysed for restenosis following PTCA. Definition of restenosis is an increase from 50% to 75% diameter stenosis at the same lesion within 1 year after angioplasty. Those with familial hypercholesterolemia, renal failure, unstable angina pectoris, bypass graft surgery within 1 month were excluded. Blood pressure, body mass index, history of smoking, fasting blood glucose, post-prandial glucose, HbA1c, cholesterol, triglycerides, number of stenotic vessels, restenosis rate were studied - 6 months before PTCA and 1, 3, 6 and 12 months after PTCA. The frequency of restenosis within 1 year of PTCA was significantly greater in poorly controlled NIDDM (75%) than in well or moderately controlled NIDDM (30-40%) or non-diabetic subjects (33%). Multivariate analysis showed that the degree of control of diabetes was significantly correlated with restenosis. Restenosis following elective and successive PTCA was significantly more frequent in poorly controlled NIDDM compared with moderately or well-controlled NIDDM or non-diabetic subjects. Multivariate analysis also showed the significant correlation between restenosis and glycemic control. These findings indicate that control of diabetes plays an important role in reducing restenosis after PTCA.