Impact of diabetes mellitus on outcomes of percutaneous coronary intervention for coronary chronic total occlusions: a meta-analysis
Presenter
Azka Latif, MD, CHI Health Creighton University Medical Center, omaha, NE
Azka Latif, MD1, Muhammad Junaid Ahsan2, Amjad Kabach, M.D.2, Vikas Kapoor2, Zoraiz Ahsan2, Mohsin Mirza3 and Dr. Andrew Michael Goldsweig, MD, MS, FSCAI4, (1)CHI Health Creighton University Medical Center, omaha, NE, (2)CHI Health Creighton University Medical Center, Omaha, NE, (3)CHI health Creighton University Medical Canter, omaha, NE, Pakistan, (4)University of Massachusetts - Baystate Medical Center, West Hartford, CT
Keywords: Acute Coronary Syndromes (ACS), Chronic Total Occlusion (CTO) and Complications
Background
Patients with diabetes mellitus (DM) have a high prevalence of coronary chronic total occlusions (CTOs). We conducted a systematic review and meta-analysis to characterize outcomes after CTO percutaneous coronary intervention (PCI) in patients without or with DM.
Methods
PubMed, EMBASE, Cochrane, and Google Scholar were queried for studies comparing non-DM vs. DM patients undergoing CTO PCI. The primary outcome was all-cause mortality at longest follow-up (at least 6 months). Secondary outcomes were major adverse cardiovascular events (MACE), target vessel revascularization (TVR), cardiac mortality, myocardial infarction (MI), and bypass surgery. We used a random effects model to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
Results
Thirteen studies with 11,064 patients met inclusion criteria (non-DM 7525, DM 3539). At longest follow-up, all-cause- mortality (OR 0.54 [0.37-0.80], p<0.0001) and MACE (OR 0.82 [0.72-0.93], p< 0.00001) were significantly lower in non-DM CTO patients (Figure). However, there were no differences in cardiac mortality, MI, TVR, or bypass surgery.
Conclusions
Non-diabetics undergoing CTO PCI have lower all-cause mortality and MACE than diabetics. Future research may determine if DM control improves diabetics' CTO PCI outcomes.
