J Transcat Intervent. 22/Feb/2019;27:eA201818.
Temporal analysis of percutaneous coronary intervention in diabetic patients. Data from a national registry
Few publications have evaluated temporal trends and outcomes of percutaneous coronary intervention in diabetic patients in the contemporary era. Our objective was to verify characteristics, procedural results and mortality of percutaneous coronary intervention in diabetic subjects in Brazil in the last 10 years.
We analyzed the percutaneous coronary interventions registered in the Brazilian National Registry of Cardiovascular Interventions (CENIC) of the Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista , from 2006 to 2016, comparing three timeframes: 2006-2008, 2009-2011, and 2012-2016. Clinical, angiographic, and procedure characteristics were analyzed, in addition to clinical outcomes and predictors of in-hospital mortality.
The sample consisted of 38,938 patients, mean age of 63.8±10.5 years, with higher prevalence of male patients (58.9%), and hypertension was the most frequent risk factor (88.6%). During this period, there was an increase in percutaneous coronary interventions in older individuals, with a past history of this procedure, in the presence of acute coronary syndrome, involving a single vessel, and with complex lesions. The use of drug-eluting stents increased, as well as use of longer and small caliber devices. There was a significant increase in procedural success, with decreased mortality rates and major adverse cardiovascular events. The mortality predictors were age, previous infarction, smoking, extent of coronary disease, left main coronary artery lesion, and clinical presentation of myocardial infarction.
In a 10-year analysis, percutaneous coronary intervention in diabetics patients in Brazil showed a progressive improvement in its results, with reduced in-hospital mortality, in spite of the increasing clinical and angiographic complexity of this population.