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Type: Artigo
Title: Association of diabetes with outcomes in patients undergoing contemporary percutaneous coronary intervention: Pre-specified subgroup analysis from the randomized GLOBAL LEADERS study
Author: Chichareon, Ply
Modolo, Rodrigo
Kogame, Norihiro
Takahashi, Kuniaki
Chang, Chun-Chin
Tomaniak, Mariusz
Botelho, Roberto
Eeckhout, Eric
Hofma, Sjoerd
Trendafilova-Lazarova, Diana
Kőszegi, Zsolt
Iñiguez, Andres
Wykrzykowska, Joanna J.
Piek, Jan J.
Garg, Scot
Hamm, Christian
Steg, Philippe Gabriel
Jüni, Peter
Vranckx, Pascal
Valgimigli, Marco
Windecker, Stephan
Onuma, Yoshinobu
Serruys, Patrick W.
Abstract: Diabetes has been well recognized as a strong predictor for adverse outcomes after percutaneous coronary intervention (PCI), however, studies in the era of drug-eluting stent and potent P2Y12 inhibitors have shown conflicting results. We aimed to assess ischemic and bleeding outcomes after contemporary PCI according to diabetic status. Methods: We studied 15,957 patients undergoing PCI for stable or acute coronary syndrome in the GLOBAL LEADERS study with known baseline diabetic status. The primary endpoint was all-cause death or new Q-wave myocardial infarction at 2 years. The secondary safety endpoint was major bleeding defined as bleeding academic research consortium (BARC) type 3 or 5. Results: A quarter of the study cohort were diabetic (4038/15,957), and these patients had a significantly higher risk of primary endpoint at 2 years compared to non-diabetics (adjusted hazard ratio [HR] 1.38; 95% confidence interval [CI] 1.17–1.63). The difference was driven by a significantly higher risk of all-cause mortality at 2 years in diabetics (adjusted HR 1.47, 95% CI 1.22–1.78). The risk of BARC 3 or 5 bleeding was comparable between the two groups (adjusted HR 1.09, 95% CI 0.86–1.39). The antiplatelet strategy (experimental versus reference strategy) had no significant effect on the rates of primary endpoint and secondary safety endpoint at 2 years in patients with and without diabetes. Conclusions: Diabetic patients had higher risk of ischemic events after PCI than non-diabetic patients, whilst bleeding risk was comparable. The outcomes of diabetic patients following PCI were not affected by the two different antiplatelet strategies
Subject: Doença da artéria coronariana
Diabetes Mellitus
Country: Países Baixos
Editor: Elsevier
Rights: Fechado
Identifier DOI: 10.1016/j.atherosclerosis.2020.01.002
Date Issue: 2020
Appears in Collections:FCM - Artigos e Outros Documentos

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