Stent fracture is associated with a higher mortality in patients with type-2 diabetes treated by implantation of a second-generation drug-eluting stent

• Published in: The International Journal of Cardiovascular Imaging 2017-12, Vol.33 (12), p.1873-1881
• Main Authors: Ge, Zhen, Liu, Zhi-Zhong, Kan, Jing, Zhang, Jun-Jie, Li, Sui-Ji, Tian, Nai-Liang, Ye, Fei, Qian, Xue-Song, Yang, Song, Chen, Meng-Xuan, Rab, Tanveer S., Chen, Shao-Liang
• Format: Article
• Language: English
• Subjects: Aged; Angiography; Cardiac Imaging; Cardiology; Chi-Square Distribution; China; Coronary Angiography; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - mortality; Coronary Artery Disease - therapy; Coronary Restenosis - etiology; Coronary Restenosis - mortality; Coronary Restenosis - therapy; Databases, Factual; Death; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - mortality; Drug delivery; Female; Heart; Heart attacks; Heart diseases; Humans; Imaging; Implantation; Implants; Kaplan-Meier Estimate; Logistic Models; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; Multivariate Analysis; Myocardial infarction; Myocardial Infarction - etiology; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Odds Ratio; Original Paper; Patients; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - instrumentation; Percutaneous Coronary Intervention - mortality; Prospective Studies; Prosthesis Design; Prosthesis Failure; Radiology; Retreatment; Risk Assessment; Risk Factors; Stents; Surgical implants; Time Factors; Treatment Outcome
• ISSN: 1569-5794; 1573-0743; 1875-8312
• DOI: 10.1007/s10554-017-1194-z

Type 2 diabetes correlates with clinical events after the implantation of a second-generation drug-eluting stent (DES). The rate and prognostic value of stent fracture (SF) in patients with diabetes who underwent DES implantation remain unknown. A total of 1160 patients with- and 2251 without- diabetes, who underwent surveillance angiography at 1 year after DES implantation between June 2004 and August 2014, were prospectively studied. The primary endpoints included the incidence of SF and a composite major adverse cardiac event [MACE, including myocardial infarction (MI), cardiac death, and target-vessel revascularization (TVR)] at 1-year follow-up and at the end of follow-up for overall patients, and target lesion failure [TLF, including cardiac death, target vessel myocardial infarction (TVMI) and target lesion revascularization (TLR)] at the end of study for SF patients. In general, diabetes was associated with a higher rate of MACE at 1-year (18.4 vs. 12.9%) and end of follow-up (24.0 vs. 18.6%, all p   0.05). Diabetic patients with SF had a 2.6-fold increase of SF-related cardiac death at the end of study and threefold increase of re-repeat TLR when compared with non-diabetic patients with SF (5.9 vs. 2.2%, p  = 0.040; 6.5 vs. 2.2%, p  = 0.032), respectively. Given the fact that diabetes is correlated with increased MACE rate, SF in diabetic patients translates into differences in mortality and re-repeat TLR compared with the non-diabetic group.