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Comparative influence of bleeding and ischemic risk factors on diabetic patients undergoing percutaneous coronary intervention with everolimus-eluting stents.

Publication ,  Journal Article
Goel, R; Cao, D; Chandiramani, R; Roumeliotis, A; Blum, M; Bhatt, DL; Angiolillo, DJ; Ge, J; Seth, A; Saito, S; Krucoff, M; Kozuma, K; Koo, K ...
Published in: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
November 2021

To investigate the impact of ischemic and bleeding risk factors on long-term clinical outcomes of patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) with everolimus-eluting stents.Second-generation drug-eluting stents have substantially improved outcomes after PCI in the general population; however, DM patients continue to experience high rates of ischemic and bleeding complications.DM patients from the pooled XIENCE V registry were divided into high or low bleeding and ischemic risk groups (HBR, LBR, HIR, and LIR) based on established bleeding (age ≥ 75 years; chronic kidney disease; anemia; prior stroke; oral anticoagulation; thrombocytopenia; prior major bleeding) and ischemic (acute coronary syndrome; prior myocardial infarction [MI]; ≥3 stents implanted; ≥3 vessels treated; ≥3 lesions treated; stent length > 60 mm; bifurcation treated with ≥2 stents; chronic total occlusion) risk factors. The primary outcomes were major adverse cardiac events (MACE; cardiac death, MI, or stent thrombosis) and major bleeding at 4-year follow-up.A total of 3,704 DM patients were divided into four groups (21.5% LBR/LIR; 39.0% LBR/HIR; 15.6% HBR/LIR; 23.9% HBR/HIR). Compared with LBR/LIR patients, those at HBR/HIR and HBR/LIR had a significantly higher risk of MACE (HR (95% CI) 2.7 (1.9-3.9) and 2.2 (1.5-3.2), respectively) and major bleeding (2.7 (1.6-4.8) and 2.6 (1.4-4.7), respectively), while LBR/HIR patients did not.Among DM patients undergoing PCI, presence of bleeding risk factors was associated with a higher risk of both ischemic and bleeding events, whereas commonly used features of ischemic risk did not impact long-term clinical outcomes.

Duke Scholars

Published In

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

DOI

EISSN

1522-726X

ISSN

1522-1946

Publication Date

November 2021

Volume

98

Issue

6

Start / End Page

1111 / 1119

Related Subject Headings

  • Treatment Outcome
  • Stents
  • Risk Factors
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Humans
  • Hemorrhage
  • Everolimus
  • Drug-Eluting Stents
  • Diabetes Mellitus
 

Citation

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Goel, R., Cao, D., Chandiramani, R., Roumeliotis, A., Blum, M., Bhatt, D. L., … Mehran, R. (2021). Comparative influence of bleeding and ischemic risk factors on diabetic patients undergoing percutaneous coronary intervention with everolimus-eluting stents. Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, 98(6), 1111–1119. https://doi.org/10.1002/ccd.29314
Journal cover image

Published In

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

DOI

EISSN

1522-726X

ISSN

1522-1946

Publication Date

November 2021

Volume

98

Issue

6

Start / End Page

1111 / 1119

Related Subject Headings

  • Treatment Outcome
  • Stents
  • Risk Factors
  • Platelet Aggregation Inhibitors
  • Percutaneous Coronary Intervention
  • Humans
  • Hemorrhage
  • Everolimus
  • Drug-Eluting Stents
  • Diabetes Mellitus