Comparative Study Of Multivessel Coronary Stenting In Patients With Diabetes

Background/Objective:Diabetes is a risk factor of cardiovascular disease.Coronary stenting in patients with diabetes often have a high rate of in-stent restenosis,but with the appearance of drug-eluting stents, the rate of in-stent restenosis and TVRs were decreased.A number of studies have shown that patients with diabetes have a high rate of multivessel diseases,and multivessel lesions completely blood flow reconstruction or stage reconstruction is safe and feasible.Research about the effectiveness of multivessel lesions completely blood flow reconstruction in diabetes is lack.This study aims to exploring the effectiveness of diabetes in patients with hemodynamic stability multivessel lesions after drug-eluting stenting.Methods:Between December2012and September2013,189patients were enrolled,among them79patients with diabetes,110patients without diabetes which are in hemodynamic stability from Department of Cardiology, Second Affiliated Hospital of Zhejiang University School of Medicine. All the patients choose the drug-eluting stents in the operation of coronary stenting in the same time or within90days.There is no difference in age, sex, smoking history, hypertension, glycosylated hemoglobin, blood lipid levels, LVEF, etc.After16to22months of follow-up, respectively record postoperative incidence of MACE and LVEF in two groups of patients.Results:There are189patients were enrolled in this study,79patients with diabetes,110patients without diabetes,and there is no difference in age, sex, smoking history, hypertension, glycosylated hemoglobin, blood lipid levels, LVEF, etc in the two groups(P>0.05).The diabetes group have a higher level of glycosylated hemoglobin(P=0.000).There are2.31±0.47coronary lesions,while2.40±0.49coronary lesions in patients without diabetes.35triple vessel disease were enrolled in diabete,while42in non-diabetes,there in no statistical differences(P=0.192, P=0.398).After16to22months of follow-up, there in no death in two groups,three patients have nonfatal myocardial infarction,one stent thrombosis,six in-stent restenosis more than fifty percents and need to TVR.However,there is only one myocardial infarction and only one patients have in stents restenosis need revascular,others between0-30%,there is no statistical differences between two groups.There is statistical significance in in-stent restenosis and TVR between the two groups (P=0.044).Conclusion:Patients with multivessel diseases and diabetes in hemodynamic stability who receive the operation of coronary stenting with drug-eluting stents in same period or staged blood flow reconstruction have no difference in all-cause mortality and myocardial infarction between the two groups, but there is a higher rate of in-stent restenosis and TVRs in diabetes,which is of great statistical significance.