Impact of Diabetes Mellitus in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents.
Circ Cardiovasc Interv
BACKGROUND: Data examining the impact of diabetes mellitus (DM) on ischemic risk after percutaneous coronary intervention in women are limited as most clinical trial participants are male. We evaluated (1) the impact of DM on ischemic outcomes in women undergoing drug-eluting stent (DES) implantation and (2) whether the outcomes of new- versus early-generation DES vary by DM status.
METHODS AND RESULTS: We pooled patient-level data of 10 448 women undergoing percutaneous coronary intervention with DES from 26 randomized trials. Baseline characteristics and 3-year clinical outcomes were stratified according to DM status (noninsulin-dependent and insulin-dependent) and DES generation. The primary end point was the composite of all-cause death or myocardial infarction. Secondary end points were definite or probable stent thrombosis and target lesion revascularization. Compared with women without DM (n=7154, 68.5%), adjusted risks (adjusted hazard ratios [95% CI]) for death or myocardial infarction among women with noninsulin-dependent DM (n=2241, 21.4%) and insulin-dependent DM (n=1053, 10.1%) were 1.30 (1.11-1.53) and 1.71 (1.41-2.07), respectively ( P
CONCLUSIONS: The presence of DM is associated with substantial, graded, and durable risks for ischemic events among women undergoing percutaneous coronary intervention with DES. The safety and efficacy profile of newer-generation DES is preserved among women without DM, while benefits are nonsignificant among women with DM.
Kidney & Diabetes
Women & Children
Baber, Usman; Stefanini, Giulio G; Giustino, Gennaro; Stone, Gregg W; Leon, Martin B; Sartori, Samantha; Aquino, Melissa; Steg, P Gabriel; Windecker, Stephan; Wijns, William; Serruys, Patrick W; Valgimigli, Marco; Morice, Marie-Claude; Camenzind, Edoardo; Weisz, Giora; Smits, Pieter C; Kandzari, David E; von Birgelen, Clemens; Dangas, George D; Galatius, Soren; Jeger, Raban V; Kimura, Takeshi; Mikhail, Ghada W; Itchhaporia, Dipti; Mehta, Laxmi; Ortega, Rebecca; Kim, Hyo-Soo; Kastrati, Adnan; Chieffo, Alaide; and Mehran, Roxana, "Impact of Diabetes Mellitus in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents." (2019). Articles, Abstracts, and Reports. 1885.