Predictive factors for in-stent late loss and non-culprit coronary lesion progression in diabetic patients undergoing drug eluting stenting

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Abstract

BACKGROUND:

Previous studies have suggested that the risks for coronary atherosclerotic plaque progression and in-stent restenosis are increased in patients with coronary heart disease combined with type 2 diabetes.

OBJECTIVE:

To explore the predictive factors for in-stent late loss and non-culprit coronary lesion progression in patients with type 2 diabetes mellitus.

METHODS:

A total of 399 stenting patients were enrolled, including 179 diabetic patients and 220 non-diabetic patients. The clinical materials, angiography parameters and biochemical markers were collected. The difference between the two groups was compared, and also we conducted subgroup analysis in the diabetic patients. Low-density lipoprotein cholesterol, hemoglobin A1c, fibrinogen and high-sensitivity C-reactive protein were detected at days 3, 120, 210 and 360 after stenting.

RESULTS AND CONCLUSION:

Compared with non-diabetic patients, the stent length (P=0.18) was longer and the stent diameter (P=0.002) was smaller in the diabetic patients. The minimal lumen diameters of post-procedure and follow-up angiography in the diabetic group were significantly decreased (P=0.001, P=0), and the diabetic patients also showed severe coronary artery stenosis instantly and within the follow-up after stenting (P=0.038, P=0.004). The follow-up angiography showed that the diabetic patients had more late loss and restenosis (P=0, P=0.097). Furthermore, in the subgroup analysis of diabetic patients, the levels of hemoglobin A1c, fibrinogen and high-sensitivity C-reactive protein were significantly increased in the patients with restenosis and non-culprit lesion progression. These findings indicate that diabetic patients appear to have the higher incidence of restenosis and non-culprit lesion progression. Moreover, hemoglobin A1c, fibrinogen and high-sensitivity C-reactive protein are effective predictors for in-stent late loss and non-culprit coronary lesion progression.

Subject headings:

drug-eluting stents; diabetes mellitus; coronary vessels

Subject headings:

Xie YX, Shi XK, Yang J, Wu G, Cheng L, Qiao R. Predictive factors for in-stent late loss and non-culprit coronary lesion progression in diabetic patients undergoing drug eluting stenting. Zhongguo Zuzhi Gongcheng Yanjiu. 2014;18(30): 4906-4910.

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