Diabetes mellitus and the clinical and angiographic outcome after coronary stent placement

Shpend Elezi, Adnan Kastrati, Jürgen Pache, Anne Wehinger, Martin Hadamitzky, Josef Dirschinger, Franz Josef Neumann, Albert Schömig

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483 Scopus citations


Objectives. The objectives of this study were to analyze the clinical and angiographic outcome of diabetic patients with successful coronary stent placement and to compare these results with those achieved after stenting in nondiabetic patients. Background. The outcome of diabetic patients treated with stent placement due to coronary artery disease has not been assessed comprehensively. Methods. This study analyzes a consecutive series of patients with successful stent placement comprising 715 patients with diabetes and 2,839 patients without diabetes. Clinical one year follow-up and angiographic control at 6 months were part of the protocol. Death, myocardial infarction and target lesion revaseularization were considered as adverse events. An automated edge detection system was used for the angiographic assessment. The primary clinical endpoint was event-free survival at one year. The primary angiographic endpoint was restenosis rate at 6 months (≥50% diameter stenosis). Results. Event-free survival was significantly lower in diabetic than in nondiabetic patients (73.1 vs. 78.5%, p < 0.001). Survival free of myocardial infarction was also significantly reduced in the diabetic group (89,9 vs. 94.4% in nondiabetics, p < 0.001). The incidence of both restenosis (37.5 vs. 28.3%, p < 0.001) and stent vessel occlusion (5.3 vs. 3.4%, p = 0.037) was significantly higher in diabetic patients. Diabetes was identified as an independent risk factor for adverse clinical events and restenosisin multivariate analyses. Conclusions. Patients with diabetes mellitus have a less favor. able clinical outcome at one year after successful stent placement as compared to the nondiabetic patients. The clinical follow-up was characterized by a higher incidence of death, myocardial infarction and reinterventions. Diabetic patients also demonstrated an increased risk for restenosis.

Original languageEnglish
Pages (from-to)1866-1873
Number of pages8
JournalJournal of the American College of Cardiology
Issue number7
StatePublished - Dec 1998


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