| Coronary angioplasty in diabetic patients. The National Heart, Lung, and Blood Institute Percutaneous Transluminal Coronary Angioplasty Registry. | |
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MedLine Citation:
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PMID: 8873655 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Patients with diabetes mellitus are at increased risk of cardiovascular disease. To date, the baseline status and subsequent outcomes of diabetic coronary angioplasty (percutaneous transluminal coronary angioplasty, or PTCA) patients with advanced atherosclerotic disease and with procedures performed across North America have not been well characterized. METHODS AND RESULTS: Data on baseline clinical and angiographic characteristics and short- and long-term outcomes of 281 diabetic and 1833 nondiabetic PTCA patients in the multicenter National Heart, Lung, and Blood Institute 1985-1986 PTCA Registry were analyzed. Diabetic patients were older, were more likely to be female, and had more comorbid baseline conditions, triplevessel disease, and atherosclerotic lesions. Angiographic success and completeness of revascularization did not differ significantly, yet diabetic patients experienced more in-hospital death (women) and nonfatal myocardial infarction. Nine-year mortality was twice as high in diabetic patients (35.9% versus 17.9%). Similarly, 9-year rates of nonfatal myocardial infarction (29.0% versus 18.5%), bypass surgery (36.7% versus 27.4%), and repeat PTCA (43.7% versus 36.5%) were higher in diabetics than in nondiabetics. In multivariate analysis, diabetes remained a significant predictor of decreased 9-year survival and other untoward events. CONCLUSIONS: Compared with nondiabetic PTCA patients, diabetic patients have more extensive and diffuse atherosclerotic disease. Despite similar probability of angiographic success, diabetic patients are more likely to suffer in-hospital death(women) and nonfatal myocardial infarction. Long-term survival and freedom from myocardial infarction and coronary revascularization is also reduced in diabetic PTCA patients. Whether PTCA or coronary bypass surgery is more suitable for these patients is currently under investigation. |
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Authors:
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K E Kip; D P Faxon; K M Detre; W Yeh; S F Kelsey; J W Currier |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Circulation Volume: 94 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1996 Oct |
Date Detail:
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Created Date: 1996-12-16 Completed Date: 1996-12-16 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1818-25 Citation Subset: AIM; IM |
Affiliation:
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University of Pittsburgh, Graduate School of Public Health, PA 15261, USA. epidkek@vms.cis.pitt.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* Coronary Angiography Coronary Artery Bypass Coronary Disease / physiopathology, radiography, therapy* Diabetic Angiopathies / physiopathology, radiography, therapy* Female Hospital Mortality Humans Male Middle Aged Mortality Myocardial Infarction / complications National Institutes of Health (U.S.)* Registries Reoperation Survival Analysis Treatment Outcome United States |
| Grant Support | |
ID/Acronym/Agency:
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HL-33292/HL/NHLBI NIH HHS |
| Comments/Corrections | |
Comment In:
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Circulation. 1996 Oct 15;94(8):1804-6
[PMID:
8873650
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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