Short- and long-term results after multivessel stenting in diabetic patients

Roxana Mehran, George D. Dangas, Yoshio Kobayashi, Alexandra J. Lansky, Gary S. Mintz, Eve D. Aymong, Martin Fahy, Jeffrey W. Moses, Gregg W. Stone, Martin B. Leon

Research output: Contribution to journalArticlepeer-review

118 Scopus citations


Objectives The present study evaluated clinical outcomes in diabetic patients after multivessel stenting. Background Multivessel angioplasty studies have reported decreased survival in diabetic patients undergoing conventional balloon angioplasty compared with coronary artery bypass graft surgery (CABG). However, several studies have demonstrated excellent procedural success and acceptable clinical outcomes after multivessel stenting. Methods Multivessel stenting was performed in 689 patients with 1,639 native coronary lesions. Patients were classified into three groups according to diabetes mellitus (DM) status: 1) no DM (501 patients/1,200 lesions); 2) DM treated with oral agents (102 patients/235 lesions); and 3) DM treated with insulin (86 patients/204 lesions). Results Procedural success was high overall. In-hospital CABG was higher in diabetics treated with insulin compared with the other two groups (3.5% vs. 0.4% vs. 1.0%, p = 0.02). There were no significant differences in the incidence of in-hospital cardiac death and myocardial infarction. Diabetic patients treated with oral agents or insulin had higher one-year target lesion revascularization rates than non-diabetic patients (25% vs. 35% vs. 16%, p < 0.001). Lower one-year survival was observed in diabetic patients treated with either oral agents or insulin, compared with non-diabetic patients (85% vs. 86% vs. 95%, p < 0.001). On multivariable analysis, DM was an independent predictor of one-year mortality, myocardial infarction, and target lesion revascularization after multivessel stenting. Conclusions Despite a high technical success rate of multivessel stenting, diabetic patients, especially those treated with insulin, have higher in-hospital CABG, higher subsequent revascularization rates, and lower one-year survival than non-diabetic patients.

Original languageEnglish
Pages (from-to)1348-1354
Number of pages7
JournalJournal of the American College of Cardiology
Issue number8
StatePublished - 21 Apr 2004
Externally publishedYes


  • BARI
  • Bypass Angioplasty Revascularization Investigation
  • CABG
  • Coronary artery bypass graft surgery
  • DM
  • Diabetes mellitus
  • MI
  • Myocardial infarction
  • PTCA
  • Percutaneous transluminal coronary angioplasty
  • Q-wave myocardial infarction
  • QMI
  • TLR


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