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Multiple predictors of coronary restenosis after drug-eluting stent implantation in patients with diabetes
  1. S J Hong1,
  2. M H Kim2,
  3. T H Ahn3,
  4. Y K Ahn4,
  5. J H Bae5,
  6. W J Shim1,
  7. Y M Ro1,
  8. D-S Lim1
  1. 1Department of Cardiology, Cardiovascular Center, Korea University Hospital, Seoul, Korea
  2. 2Department of Cardiology, Donga University Hospital, Pusan, Korea
  3. 3Department of Cardiology, Gachon University Hospital, Incheon, Korea
  4. 4Department of Cardiology, Chonnam University Hospital, Kwangju, Korea
  5. 5Department of Cardiology, Konyang University Hospital, Daejeon, Korea
  1. Correspondence to:
    Dr Do-Sun Lim
    Department of Cardiology, Cardiovascular Center, Korea University Hospital, 126-1, 5ka, Anam-dong, Sungbuk-ku, Seoul 136-705, Korea; dslmd{at}kumc.or.kr

Abstract

Objectives: To identify parameters influencing the likelihood of restenosis after implantation of drug-eluting stents (DES) in patients with diabetes.

Methods: Stented patients (n  =  840) with DES were retrospectively reviewed for inclusion in the study from the Multicenter PCI Database Registry. From this database, 211 (25.1%) of 840 patients with six-month angiographic follow up had diabetes. Predictors of coronary restenosis were identified with univariate and multivariate logistic regression analyses.

Results: Restenosis occurred in 92 of 629 (14.6%) patients without diabetes and in 44 (20.9%) of 211 patients with diabetes (p < 0.001). Multivariate parameters for predicting restenosis in the diabetic group were current smoking (odds ratio (OR) 1.923, 95% confidence interval (CI) 1.055 to 4.725, p  =  0.036), higher C reactive protein concentration (OR 1.031, 95% CI 1.011 to 1.075, p  =  0.043), use of the paclitaxel-eluting stent (OR 2.638, 95% CI 1.338 to 5.200, p  =  0.005), longer stent length (OR 1.065, 95% CI 1.021 to 1.119, p  =  0.033), smaller reference diameter before DES implantation (OR 0.501, 95% CI 0.110 to 0.965, p  =  0.040), smaller reference diameter (OR 0.455, 95% CI 0.120 to 0.814, p  =  0.026) and minimum lumen diameter (OR 0.447, 95% CI 0.068 to 0.876, p  =  0.039) after DES implantation.

Conclusion: Even with the introduction of DES, diabetes remains a significant predictor of coronary restenosis, especially in cases of a small baseline vessel size, small vessel size after percutaneous coronary intervention, longer stent length, use of the paclitaxel-eluting stent, current smoking and high C reactive protein concentration.

  • BMS, bare metal stents
  • CRP, C reactive protein
  • DES, drug-eluting stents
  • IVUS, intravascular ultrasound
  • MLD, minimum lumen diameter
  • NRG, no restenosis group
  • PCI, percutaneous coronary intervention
  • OR, odds ratio
  • RG, restenosis group

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Footnotes

  • Published Online First 31 January 2006

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