Comparison of the predictors of coronary restenosis after drug-eluting stent implantation in diabetic and nondiabetic patients

Soon Jun Hong, Hyun Kim Moo, Hoon Ahn Tae, Wan Joo Shim, Seong-Mi Park, Il Choi Jong, Hyung Joon Joo, Yong Shin Seung, Sang Yeob Lim, Do-Sun Lim

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3 Citations (Scopus)

Abstract

Background and Objectives: Coronary restenosis after drug-eluting stent (DES) implantation occurs more frequently in diabetic patients than in nondiabetic patients. We compared the parameters influencing the likelihood of restenosis after DES implantation in diabetic and nondiabetic patients. Subjects and Methods: Patients who underwent DES implantation (619 patients with 917 lesions, 211 diabetics and 408 nondiabetics), followed by 8 months coronary angiogram, were retrospectively identified using the percutaneous coronary intervention database and included in the present study [AH1]. Predictors of restenosis were identified by multivariate logistic regression analyses. Results: The baseline characteristics of the patients, such as sex, body mass index, hypertension, hyperlipidemia, and smoking status, were similar between the diabetic and nondiabetic patients. Restenosis (>50% of the diameter stenosis) occurred in 32 of 408 (7.8%) nondiabetic patients and in 32 (15.2%) of 211 diabetic patients (p<0.001). The use of a paclitaxel-eluting stent (PES), a higher level of C-reactive protein (CRP), longer stent length, smaller reference diameter (RD) before DES implantation, smaller RD and minimal lumen diameter after DES implantation were common predictors of restenosis in both the diabetic and non-diabetic patients after multivariate analyses. Current smoking status [odds ratio (OR)=3.213, 95% confidence interval (CI) 1.458 to 7.080 p=0.004] and right coronary lesions (OR=2.444, 95% CI 1.048 to 5.703, p=0.039) were predictors of restenosis in the diabetic patients, while higher body mass index (OR=1.322, 95% CI 1.054 to 1.659, p=0.016) and A-type lesions (OR=0.108, 95% CI 0.022 to 0.530, p=0.006) were predictors of restenosis in the nondiabetic patients. Conclusion: The use of PESs and higher levels of CRP were associated with restenosis regardless of the presence of diabetes. Moreover, small baseline and post-PCI reference diameter and longer stent length remained significant angiographic predictors of restenosis in both diabetic and nondiabetic patients, even in the era of DES implantation.

Original languageEnglish
Pages (from-to)530-537
Number of pages8
JournalKorean Circulation Journal
Volume37
Issue number11
Publication statusPublished - 2007 Nov 1

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Coronary Restenosis
Drug-Eluting Stents
Odds Ratio
Confidence Intervals
Stents
C-Reactive Protein
Body Mass Index
Smoking
Percutaneous Coronary Intervention
Paclitaxel
Hyperlipidemias

Keywords

  • Coronary restenosis
  • Diabetes mellitus
  • Drug-eluting stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

Cite this

Comparison of the predictors of coronary restenosis after drug-eluting stent implantation in diabetic and nondiabetic patients. / Hong, Soon Jun; Moo, Hyun Kim; Tae, Hoon Ahn; Shim, Wan Joo; Park, Seong-Mi; Jong, Il Choi; Joo, Hyung Joon; Seung, Yong Shin; Lim, Sang Yeob; Lim, Do-Sun.

In: Korean Circulation Journal, Vol. 37, No. 11, 01.11.2007, p. 530-537.

Research output: Contribution to journalArticle

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abstract = "Background and Objectives: Coronary restenosis after drug-eluting stent (DES) implantation occurs more frequently in diabetic patients than in nondiabetic patients. We compared the parameters influencing the likelihood of restenosis after DES implantation in diabetic and nondiabetic patients. Subjects and Methods: Patients who underwent DES implantation (619 patients with 917 lesions, 211 diabetics and 408 nondiabetics), followed by 8 months coronary angiogram, were retrospectively identified using the percutaneous coronary intervention database and included in the present study [AH1]. Predictors of restenosis were identified by multivariate logistic regression analyses. Results: The baseline characteristics of the patients, such as sex, body mass index, hypertension, hyperlipidemia, and smoking status, were similar between the diabetic and nondiabetic patients. Restenosis (>50{\%} of the diameter stenosis) occurred in 32 of 408 (7.8{\%}) nondiabetic patients and in 32 (15.2{\%}) of 211 diabetic patients (p<0.001). The use of a paclitaxel-eluting stent (PES), a higher level of C-reactive protein (CRP), longer stent length, smaller reference diameter (RD) before DES implantation, smaller RD and minimal lumen diameter after DES implantation were common predictors of restenosis in both the diabetic and non-diabetic patients after multivariate analyses. Current smoking status [odds ratio (OR)=3.213, 95{\%} confidence interval (CI) 1.458 to 7.080 p=0.004] and right coronary lesions (OR=2.444, 95{\%} CI 1.048 to 5.703, p=0.039) were predictors of restenosis in the diabetic patients, while higher body mass index (OR=1.322, 95{\%} CI 1.054 to 1.659, p=0.016) and A-type lesions (OR=0.108, 95{\%} CI 0.022 to 0.530, p=0.006) were predictors of restenosis in the nondiabetic patients. Conclusion: The use of PESs and higher levels of CRP were associated with restenosis regardless of the presence of diabetes. Moreover, small baseline and post-PCI reference diameter and longer stent length remained significant angiographic predictors of restenosis in both diabetic and nondiabetic patients, even in the era of DES implantation.",
keywords = "Coronary restenosis, Diabetes mellitus, Drug-eluting stent",
author = "Hong, {Soon Jun} and Moo, {Hyun Kim} and Tae, {Hoon Ahn} and Shim, {Wan Joo} and Seong-Mi Park and Jong, {Il Choi} and Joo, {Hyung Joon} and Seung, {Yong Shin} and Lim, {Sang Yeob} and Do-Sun Lim",
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T1 - Comparison of the predictors of coronary restenosis after drug-eluting stent implantation in diabetic and nondiabetic patients

AU - Hong, Soon Jun

AU - Moo, Hyun Kim

AU - Tae, Hoon Ahn

AU - Shim, Wan Joo

AU - Park, Seong-Mi

AU - Jong, Il Choi

AU - Joo, Hyung Joon

AU - Seung, Yong Shin

AU - Lim, Sang Yeob

AU - Lim, Do-Sun

PY - 2007/11/1

Y1 - 2007/11/1

N2 - Background and Objectives: Coronary restenosis after drug-eluting stent (DES) implantation occurs more frequently in diabetic patients than in nondiabetic patients. We compared the parameters influencing the likelihood of restenosis after DES implantation in diabetic and nondiabetic patients. Subjects and Methods: Patients who underwent DES implantation (619 patients with 917 lesions, 211 diabetics and 408 nondiabetics), followed by 8 months coronary angiogram, were retrospectively identified using the percutaneous coronary intervention database and included in the present study [AH1]. Predictors of restenosis were identified by multivariate logistic regression analyses. Results: The baseline characteristics of the patients, such as sex, body mass index, hypertension, hyperlipidemia, and smoking status, were similar between the diabetic and nondiabetic patients. Restenosis (>50% of the diameter stenosis) occurred in 32 of 408 (7.8%) nondiabetic patients and in 32 (15.2%) of 211 diabetic patients (p<0.001). The use of a paclitaxel-eluting stent (PES), a higher level of C-reactive protein (CRP), longer stent length, smaller reference diameter (RD) before DES implantation, smaller RD and minimal lumen diameter after DES implantation were common predictors of restenosis in both the diabetic and non-diabetic patients after multivariate analyses. Current smoking status [odds ratio (OR)=3.213, 95% confidence interval (CI) 1.458 to 7.080 p=0.004] and right coronary lesions (OR=2.444, 95% CI 1.048 to 5.703, p=0.039) were predictors of restenosis in the diabetic patients, while higher body mass index (OR=1.322, 95% CI 1.054 to 1.659, p=0.016) and A-type lesions (OR=0.108, 95% CI 0.022 to 0.530, p=0.006) were predictors of restenosis in the nondiabetic patients. Conclusion: The use of PESs and higher levels of CRP were associated with restenosis regardless of the presence of diabetes. Moreover, small baseline and post-PCI reference diameter and longer stent length remained significant angiographic predictors of restenosis in both diabetic and nondiabetic patients, even in the era of DES implantation.

AB - Background and Objectives: Coronary restenosis after drug-eluting stent (DES) implantation occurs more frequently in diabetic patients than in nondiabetic patients. We compared the parameters influencing the likelihood of restenosis after DES implantation in diabetic and nondiabetic patients. Subjects and Methods: Patients who underwent DES implantation (619 patients with 917 lesions, 211 diabetics and 408 nondiabetics), followed by 8 months coronary angiogram, were retrospectively identified using the percutaneous coronary intervention database and included in the present study [AH1]. Predictors of restenosis were identified by multivariate logistic regression analyses. Results: The baseline characteristics of the patients, such as sex, body mass index, hypertension, hyperlipidemia, and smoking status, were similar between the diabetic and nondiabetic patients. Restenosis (>50% of the diameter stenosis) occurred in 32 of 408 (7.8%) nondiabetic patients and in 32 (15.2%) of 211 diabetic patients (p<0.001). The use of a paclitaxel-eluting stent (PES), a higher level of C-reactive protein (CRP), longer stent length, smaller reference diameter (RD) before DES implantation, smaller RD and minimal lumen diameter after DES implantation were common predictors of restenosis in both the diabetic and non-diabetic patients after multivariate analyses. Current smoking status [odds ratio (OR)=3.213, 95% confidence interval (CI) 1.458 to 7.080 p=0.004] and right coronary lesions (OR=2.444, 95% CI 1.048 to 5.703, p=0.039) were predictors of restenosis in the diabetic patients, while higher body mass index (OR=1.322, 95% CI 1.054 to 1.659, p=0.016) and A-type lesions (OR=0.108, 95% CI 0.022 to 0.530, p=0.006) were predictors of restenosis in the nondiabetic patients. Conclusion: The use of PESs and higher levels of CRP were associated with restenosis regardless of the presence of diabetes. Moreover, small baseline and post-PCI reference diameter and longer stent length remained significant angiographic predictors of restenosis in both diabetic and nondiabetic patients, even in the era of DES implantation.

KW - Coronary restenosis

KW - Diabetes mellitus

KW - Drug-eluting stent

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