Skip to main content
SpringerLink
Log in

Influence of diabetes on >10-year outcomes after percutaneous coronary intervention

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

There are few reports showing the relationship between diabetes and the long-term outcome following percutaneous coronary intervention (PCI) in Asians. As well, the association between glycosylated hemoglobin (HbA1c) level and outcome remains controversial. In this analysis, 748 Japanese patients including 298 with diabetes (DM) and 450 without diabetes (non-DM) who underwent PCI from 1984 to 1992 were evaluated over the long term. The mean follow-up was 12.0 ± 3.6 years. There were 47 (15.8%) total deaths in DM and 41 (9.1%) in non-DM [hazard ratio (HR) 1.71, 95% confidence interval (CI) 1.11–2.65, P = 0.013] and 28 (9.4%) cardiovascular deaths in DM and 19 (4.2%) in non-DM (HR 2.09, 95% CI 1.14–3.81, P = 0.016). Among DM, increased HbA1c was associated with both total (HR 1.25, 95% CI 1.03–1.53, P = 0.024) and cardiovascular (HR 1.30, 95% CI 1.00–1.69, P = 0.048) mortality. Even in Asians, DM showed an increased mortality following PCI. Among DM, increased HbA1c level was also associated with mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kannel WB, McGee DL (1979) Diabetes and cardiovascular disease: the Framingham Study. JAMA 241:2035–2038

    Article  PubMed  CAS  Google Scholar 

  2. Haffner SM, Lehto S, Rönnemaa T, Pyorala K, Laakso M (1998) Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without myocardial infarction. N Engl J Med 339:229–234

    Article  PubMed  CAS  Google Scholar 

  3. McGuire DK, Emanuelsson H, Granger CB, Magnus Ohman E, Moliterno DJ, White HD, Ardissino D, Box JW, Califf RM, Topol EJ (2000) Influence of diabetes mellitus on clinical outcomes across the spectrum of acute coronary syndrome; findings from the GUSTO-IIb study: GUSTO IIb Investigators. Eur Heart J 21:1750–1758

    Article  PubMed  CAS  Google Scholar 

  4. Abbud ZA, Shindler DM, Wison AC, Kostis JB (1995) Effect of diabetes mellitus on short-and long-term mortality rates of patients with acute myocardial infarction: a statewide study. Am Heart J 130:51–58

    Article  PubMed  CAS  Google Scholar 

  5. Malmberg K, Yusuf S, Gerstein HC, Brown J, Zhao F, Hunt D, Piegas L, Calvin J, Keltai M, Budaj A (2000) Impact of diabetes on long-term prognosis in patients with unstable angina and non-Q wave myocardial infarction: results of the OASIS (Organization to Assess Strategies for Ischemic Syndromes) Registry. Circulation 102:1014–1019

    PubMed  CAS  Google Scholar 

  6. BARI Investigators (1997) Influence of diabetes on 5-year mortality and morbidity in a randomized trial comparing CABG and PTCA in patients with multivessel disease: the Bypass Angioplasty Revascularization Investigation (BARI). Circulation 96:1761–1769

    Google Scholar 

  7. Kurbaan AS, Bowker TJ, Ilsley CD, Sigwart U, Rickards AF, CABRI Investigators (Coronary Angioplasty versus Bypass Revascularization Investigation) (2001) Difference in the mortality of the CABRI diabetic and nondiabetic populations and its relation to coronary artery disease and the revascularization mode. Am J Cardiol 87:947–950

    Article  PubMed  CAS  Google Scholar 

  8. Barsness GW, Peterson ED, Ohman EM, Nelson CL, DeLong ER, Reves JG, Smith PK, Anderson RD, Jones RH, Mark DB, Califf RM (1997) Relationship between diabetes mellitus and long-term survival after coronary bypass and angioplasty. Circulation 96:2551–2556

    PubMed  CAS  Google Scholar 

  9. Rensing BJ, Hermans WR, Vos J, Tijssen JG, Rutch W, Danchin N, Heyndrickx GR, Mast EG, Wijns W, Serruys PW (1993) Luminal narrowing after percutaneous transluminal coronary angioplasty: a study of clinical, procedural and lesional factors related to long-term angiographic outcome. Circulation 88:975–985

    PubMed  CAS  Google Scholar 

  10. Weintraub WS, Kosinski AS, Brown CL 3rd, King SB 3rd (1993) Can restenosis after coronary angioplasty be predicted from clinical variables? J Am Coll Cardiol 21:6–14

    Article  PubMed  CAS  Google Scholar 

  11. Kip KE, Faxon DP, Detre KM, Yeh W, Kelsey SF, Currier JW (1996) Coronary angioplasty in diabetic patients: the National, Heart, Lung, and Blood Institute Percutaneous Transluminal Coronary Angioplasty Registry. Circulation 94:1818–1825

    PubMed  CAS  Google Scholar 

  12. van Domburg RT, Foley DP, de Feyter PJ, van der Giessen W, van den Brand MJBM, Serruys PW (2001) Long-term clinical outcome after coronary balloon angioplasty. Identification of population at low risk of recurrent events during 17 years of follow-up. Eur Heart J 22:934–941

    Article  PubMed  Google Scholar 

  13. Elezi S, Kastrati A, Pache J, Wehinger A, Hadamitzky M, Dirschinger J, Neumann FJ, Schomig A (1998) Diabetes mellitus and the clinical and angiographic outcome after coronary stent placement. J Am Coll Cardiol 32:1866–1873

    Article  PubMed  CAS  Google Scholar 

  14. Abizaid A, Kornowski R, Mintz GS, Hong MK, Abizaid AS, Mehran R, Pichard AD, Kent KM, Satler LF, Wu H, Popma JJ, Leon MB (1998) The influence of diabetes mellitus on acute and late clinical outcomes following coronary stent implantation. J Am Coll Cardiol 32:584–589

    Article  PubMed  CAS  Google Scholar 

  15. Wilson SR, Vakili BA, Sherman W, Sanborn TA, Brown DL (2004) Effect of diabetes on long-term mortality following contemporary percutaneous coronary intervention. Diabetes Care 27:1137–1142

    Article  PubMed  Google Scholar 

  16. Seidell JC, Kahn HS, Williamson DF, Lissner L, Valdez R (2001) Report from a Centers for Disease Control and Prevention Workshop on use of adult anthropometry for public health and primary health care. Am J Clin Nutr 73:123–126

    PubMed  CAS  Google Scholar 

  17. Ko GTC, Chan JC, Cockram CS, Woo J (1999) Prediction of hypertension, diabetes, dyslipidaemia or albuminuria using simple anthropometric indexes in Hong Kong Chinese. Int J Obes Relat Metab Disord 23:1136–1142

    Article  PubMed  CAS  Google Scholar 

  18. Kuusisto J, Mykkänen L, Pyörälä K, Laakso M (1994) NIDDM and its metabolic control predict coronary heart disease in elderly subjects. Diabetes 43:960–967

    Article  PubMed  CAS  Google Scholar 

  19. UK Prospective Diabetes Study Group (1998) Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:837–853

    Article  Google Scholar 

  20. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR (2000) Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 321:405–412

    Article  PubMed  CAS  Google Scholar 

  21. Hasdai D, Rizza RA, Grill DE, Scott CG, Garratt KN, Holmes DR (2001) Glycemic control and outcome of diabetic patients after successful percutaneous coronary revascularization. Am Heart J 141:117–231

    Article  PubMed  CAS  Google Scholar 

  22. Shah B, Liou M, Grossi E, Mass H, Lorin JD, Danoff A, Sedlis SP (2005) Relation of elevated periprocedural blood glucose to long-term survival after percutaneous coronary intervention. Am J Cardiol 96:543–546

    Article  PubMed  CAS  Google Scholar 

  23. Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977–986

    Article  Google Scholar 

  24. Malmberg K, for the DIGAMI (Diabetes Mellitus Insulin Glucose Infusion in Acute Myocardial Infarction) Study Group (2000) Prospective randomised study of intensive insulin treatment on long-term survival after acute myocardial infarction in patients with diabetes mellitus. BMJ 314:1512–1515

    Google Scholar 

  25. Hasdai D, Bell MR, Grill DE, Berger PB, Garratt KN, Rihal CS, Hammes LN, Holmes DR Jr (1997) Outcome ≥10 years after successful percutaneous transluminal coronary angioplasty. Am J Cardiol 79:1005–1011

    Article  PubMed  CAS  Google Scholar 

  26. Otsuka Y, Miyazaki S, Okumura H, Yasuda S, Daikoku S, Morii I, Sutani Y, Goto Y, Nonogi H (2000) Abnormal glucose tolerance, not small vessel diameter, is a determinant of long-term prognosis in patients treated with balloon coronary angioplasty. Eur Heart J 21:1790–1796

    Article  PubMed  CAS  Google Scholar 

  27. Robertson BJ, Gascho JA, Gabbay RA, McNulty PH (2004) Usefulness of hyperglycemia in predicting renal and myocardial injury in patients with diabetes mellitus undergoing percutaneous coronary intervention. Am J Cardiol 94:1027–1029

    Article  PubMed  Google Scholar 

  28. Davi G, Catalano I, Averna M, Notarbartolo A, Strano A, Ciabattoni G, Patrono C (1990) Thromboxane biosynthesis and platelet function in type II diabetes mellitus. N Engl J Med 322:1769–1774

    PubMed  CAS  Google Scholar 

  29. Jain SK, Nagi DK, Slavin BM, Lumb PJ, Yudkin JS (1993) Insulin therapy in type 2 diabetic subjects suppresses plasminogen activator inhibitor (PAI1) activity and proinsulin-like molecules independently of glycaemic control. Diabet Med 10:27–32

    Article  PubMed  CAS  Google Scholar 

  30. Watanabe I, Nagao K, Tani S, Masuda N, Yahara T, Ohguchi S, Kanmatsuse K, Kushiro T (2006) Reperfusion strategy for acute myocardial infarction in elderly patients aged 75 to 80 years. Heart Vessels 21:236–241

    Article  PubMed  Google Scholar 

  31. Lee RJ, Shin KN, Lee SH, Shyu KG, Chiu CZ, Lin SC, Hung HF, Liou JY, Cheng JJ, Kuan P (2007) Predictors of long-term outcomes in patients after elective stent implantation for unprotected left main coronary artery. Heart Vessels 22:99–103

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Takatoshi Kasai, Katsumi Miyauchi, Naozumi Kubota, Takeshi Kurata & Hiroyuki Daida

  2. Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan

    Kan Kajimoto

Authors
  1. Takatoshi Kasai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katsumi Miyauchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kan Kajimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Naozumi Kubota
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takeshi Kurata
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hiroyuki Daida
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katsumi Miyauchi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kasai, T., Miyauchi, K., Kajimoto, K. et al. Influence of diabetes on >10-year outcomes after percutaneous coronary intervention. Heart Vessels 23, 149–154 (2008). https://doi.org/10.1007/s00380-007-1021-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-007-1021-x

Key words

Search

Navigation