Background:

Diabetes mellitus (DM) has been associated with an increase in adverse outcomes in patients treated with coronary angioplasty, compared to non-diabetic patients.

Objective:

To evaluate the risk of major adverse cardiovascular events in diabetic patients, stratified according to the treatment (non-insulin dependent or insulin-dependent), in a population of unselected patients treated with coronary angioplasty.

Methods:

Registry-based analysis of patients with coronary artery disease undergoing percutaneous coronary intervention from March 2009 to June 2018, according presence of DM stratified according to the established treatment for the metabolic disorder: insulin-dependent DM (ID -DM) and non-insulin dependent DM (NID -DM). An adjusted Cox regression model was applied to evaluate the relationship between the diabetic status and the risk of major adverse cardiovascular events.

Results:

A total of 6313 patients were included (mean follow-up 4.1 ± 1.8 years), with a global prevalence of DM of 22,8% (non-insulin dependent DM 19,1%, insulin-dependent DM 3,8%). Diabetic patients showed a higher risk profile, particularly those with ID-DM. At the average follow-up, the adjusted risk of MACE was similar between Non-DM patients and the NIR-DM patients (HR 1,02 [0,81-1,27], p 0.85). In relation to DM-IR patients, it was observed a higher risk of MACE in comparison to Non-DM (HR 1,73 [1,20-2,49], p 0.003) and NIR-DM (HR 1,65 [1,10-2,48], p 0.015). A significant interaction was observed between the diabetic status and the risk of MACE according to the indication of the percutaneous coronary artery intervention (pint 0.045).

Conclusions:

In our registry of patients undergoing PCI, with long-term follow-up, DM patients had a higher risk of MACE. The risk of MACE was particularly increased in ID-DM patients. However, there were no significant differences in the risk of MACE between DM-NIR and non-DM patients.

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