Autoren:	Anadol, Remzi Schnitzler, Katharina Lorenz, Liv Weissner, Melissa Ullrich, Helen Polimeni, Alberto Münzel, Thomas Gori, Tommaso
Titel:	Three-years outcomes of diabetic patients treated with coronary bioresorbable scaffolds
Online-Publikationsdatum:	14-Jan-2019
Erscheinungsdatum:	2018
Sprache des Dokuments:	Englisch
Zusammenfassung/Abstract:	Background: Diabetes is among the strongest predictors of outcome after coronary artery stenting and the incidence of negative outcomes is still high in this specific group. Data of long-term outcomes comparing diabetic patients with non-diabetic patients treated with bioresorbable scaffolds are still incomplete. This work evaluates the long-term outcomes after implantation of a coronary bioresorbable scaffold (BRS) in diabetic patients compared to non-diabetics. Methods: Patients who received at least one Absorb BRS in the time of May 2012 to December 2014 were enrolled into this single-center registry. Quantitative coronary angiography (QCA) was performed. Results: Six hundred fifty seven patients including 138 patients (21%, mean age 65 ± 11, 78% male) with Diabetes were enrolled. Patients in the diabetic group were significantly older, were more likely to suffer from hypertension and hyperlipidemia and had more often a prior stroke or TIA as well as a reduced renal function (all P < 0.05). The initial stenosis was less severe in the diabetic group (74.8% vs. 79.6%, P = 0.036), but the residual stenosis after BRS implantation exceeded that of the control group (16.7% vs. 13.8%, P = 0.006). History of diabetes had no impact on the incidence of events within one year after BRS implantation. Beyond 1 year, diabetic patients had a higher incidence of cardiovascular death (6.9 vs. 1.4%, HR:5.37 [1.33–21.71], P = 0.001), scaffold restenosis (17.6 vs. 7.8%, HR:3.56 [1.40–9.05], P < 0.0001) and target lesion revascularization (P = 0.016). These results were confirmed in the propensity score analysis. In both diabetics and non-diabetics, there was a strong association (HR:18.6 [4.7–73.3]) between the risk of restenosis and the technique used at implantation; in contrast, the impact of vessel size was more manifest in nondiabetics than in diabetic patients, and an increased risk of restenosis was demonstrated for both large and small vessels. Conclusion: As for metal stents, beyond one year after implantation, diabetes was associated with an increased incidence of scaffold restenosis and related outcomes. This negative impact of diabetes was reset when an optimal implantation technique was used. Keywords: Diabetes, Bioresorbable scaffolds, Coronary artery disease
DDC-Sachgruppe:	610 Medizin 610 Medical sciences
Veröffentlichende Institution:	Johannes Gutenberg-Universität Mainz
Organisationseinheit:	FB 04 Medizin
Veröffentlichungsort:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-276
Version:	Published version
Publikationstyp:	Zeitschriftenaufsatz
Nutzungsrechte:	CC BY
Informationen zu den Nutzungsrechten:	https://creativecommons.org/licenses/by/4.0/
Zeitschrift:	BMC cardiovascular disorders 18
Seitenzahl oder Artikelnummer:	Art. 92
Verlag:	BioMed Central
Verlagsort:	London
Erscheinungsdatum:	2018
ISSN:	1471-2261
URL der Originalveröffentlichung:	http://dx.doi.org/10.1186/s12872-018-0811-7
DOI der Originalveröffentlichung:	10.1186/s12872-018-0811-7
Enthalten in den Sammlungen:	JGU-Publikationen