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Clinical impact of diabetes mellitus on 2-year clinical outcomes following PCI with second-generation drug-eluting stents; Landmark analysis findings from patient registry: Pooled analysis of the Korean multicenter drug-eluting stent registry

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Author(s)
Cheol Hyun LeeSang-Woong ChoiSeung-Woon JunJongmin HwangIn-Cheol KimYun-Kyeong ChoHyoung-Seob ParkHyuck-Jun YoonHyungseop KimChang-Wook NamSeongwook HanKwon-Bae KimSeung-Ho Hur
Keimyung Author(s)
Lee, Cheol HyunHwang, Jong MinKim, In CheolCho, Yun KyeongPark, Hyoung SeobYoon, Hyuck JunKim, Hyung SeopNam, Chang WookHan, Seong WookKim, Kwon BaeHur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
PLoS One
Issued Date
2020
Volume
15
Issue
6
Abstract
Background:
Patients with diabetes mellitus are at an increased risk for adverse clinical events following percutaneous coronary interventions (PCI). However, the clinical impact of diabetes mellitus (DM) on second-generation drug-eluting stent (DES) implantation is not well-known. The aim of the current analysis was to examine the clinical impact of DM on clinical outcomes and the time sequence of associated risks in patients treated with second-generation DES.

Methods:
Using patient-level data from two stent-specific, all-comer, prospective DES registries, we evaluated 1,913 patients who underwent PCI with second-generation DES between Feb 2009 and Dec 2013. The primary outcomes assessed were two-year major cardiac adverse events (MACE), composite endpoints of death from any cause, myocardial infarction (MI), and any repeat revascularization. We classified 0-1 year as the early period and 1-2 years as the late period. Landmark analyses were performed according to diabetes mellitus status.

Results:
There were 1,913 patients with 2,614 lesions included in the pooled dataset. The median duration of clinical follow-up in the overall population was 2.0 years (interquartile range 1.9-2.1). Patients with DM had more cardiovascular risk factors than patients without DM. In multivariate analyses, the presence of DM and renal failure were strong predictors of MACE and target-vessel revascularization (TVR). After inverse probability of treatment weighting (IPTW) analyses, patients with DM had significantly increased rates of 2-year MACE (HR 2.07, 95% CI; 1.50-2.86; P <0.001). In landmark analyses, patients with DM had significantly higher rates of MACE in the early period (0-1 year) (HR 3.04, 95% CI; 1.97-4.68; P < 0.001) after IPTW adjustment, but these findings or trends were not observed in the late period (1-2 year) (HR 1.24, 95% CI; 0.74-2.07; P = 0.41).

Conclusions:
In the second-generation DES era, the clinical impact of DM significantly increased the 2-year event rate of MACE, mainly caused by clinical events in the early period (0-1 year). Careful observation of patients with DM is advised in the early period following PCI with second-generation DES.
Keimyung Author(s)(Kor)
이철현
황종민
김인철
조윤경
박형섭
윤혁준
김형섭
남창욱
한성욱
김권배
허승호
Publisher
School of Medicine (의과대학)
Citation
Cheol Hyun Lee et al. (2020). Clinical impact of diabetes mellitus on 2-year clinical outcomes following PCI with second-generation drug-eluting stents; Landmark analysis findings from patient registry: Pooled analysis of the Korean multicenter drug-eluting stent registry. PLoS One, 15(6), e0234362. doi: 10.1371/journal.pone.0234362
Type
Article
ISSN
1932-6203
Source
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0234362
DOI
10.1371/journal.pone.0234362
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43275
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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