RESULTS OF PERCUTANEOUS CORONARY INTERVENTION IN ELDERLY DIABETIC PATIENTS

Cover Page


Cite item

Full Text

Abstract

Objective: Our aim was to compare results of the percutaneous coronary intervention (PCI) with drug eluting stent (DES) and bare metal stent (BMS) in older patients with coronary heart disease (CHD) and diabetes mellitus (DM) type 2. Methods: Patients (>65 years) with DM type 2 were divided into two groups: the 1st group — 58 patients after PCI with DES, the 2nd group — 62 patients after PCI with BMS. The average follow-up period was 32.6±8.0 months. The end-points of the study were death, non-fatal myocardial infarction and restenosis of the target stenosis. Results: Endovascular treatment of patients older than 65 years with DM is highly effective and safe despite the complexity of coronary lesions. There are no significant differences in the rate of early (hospital) complications in two groups. Also, we did not find differences in three-year mortality between the groups. But the incidence of myocardial infarction in the groups with DES and BMS was 9% and 18% respectively (р =0.039). Major adverse cardiovascular events (death, myocardial infarction and restenosis of the target stenosis) frequency was also lower in the group with DES compared to BMS (36% and 61% respectively, p =0.001). Conclusion: Endovascular treatment of patients older than 65 years with DM type 2 is a highly effective and safe method despite the complexity of coronary lesions. PCI with DES compared to BMS in older patients with DM is associated with improvement of medium-term results and decreases the number of cardiovascular events.

 

About the authors

I. Yu. Sigaev

Bakulev Scientific Centre of Cardiovascular Surgery, Moscow, Russian Federation

Author for correspondence.
Email: sigaev1958@mail.ru

доктор медицинских наук, профессор, руководитель отделения хирургии сочетанных заболе-
ваний коронарных и магистральных артерий НЦ ССХ им. А.Н.Бакулева
Адрес: 119049, Москва, Ленинский пр-т, д. 8, к. 7, тел.: +7 (499) 236-82-65

Россия

R. R. Yarbekov

Bakulev Scientific Centre of Cardiovascular Surgery, Moscow, Russian Federation

Email: yarbekov@mail.ru

кандидат медицинских наук, докторант отделения хирургии сочетанных заболеваний
коронарных и магистральных артерий НЦ ССХ им. А.Н.Бакулева
Адрес: Москва, Ленинский пр-т, д. 8, к. 7, тел.: +7 (499) 236-92-53

Россия

N. A. Chigogidze

Bakulev Scientific Centre of Cardiovascular Surgery, Moscow, Russian Federation

Email: sigaev1958@mail.ru

кандидат медицинских наук, руководитель отделения рентгенохирургических, элек-
трофизиологических методов исследования, лечения и апробации новейших технологий НЦ ССХ им. А.Н. Бакулева
Адрес: 119049, Москва, Ленинский пр-т, д. 8, к. 7, тел.: +7 (499) 236-92-53

Россия

L. G. Enokyan

Bakulev Scientific Centre of Cardiovascular Surgery, Moscow, Russian Federation

Email: yenoqyanluci@rambler.ru

кандидат медицинских наук, старший научный сотрудник группы ультразвуковых иссле-
дований сердечно-сосудистых и органных патологии НЦ ССХ им. А.Н. Бакулева
Адрес: 119049, Москва, Ленинский пр-т, д. 8, к. 7, тел.: +7 (499) 236-92-53

Россия

M. A. Keren

Bakulev Scientific Centre of Cardiovascular Surgery, Moscow, Russian Federation

Email: milenamailru@mail.ru

доктор медицинских наук, научный сотрудник отделения хирургии сочетанных заболе-
ваний коронарных и магистральных артерий НЦ ССХ им. А.Н. Бакулева
Адрес: 119049, Москва, Ленинский пр-т, д. 8, к. 7, тел.: +7 (499) 236-92-53

Россия

M. V. Starostin

Bakulev Scientific Centre of Cardiovascular Surgery, Moscow, Russian Federation

Email: m_starostin@mai.ru

кандидат медицинских наук, научный сотрудник отделения хирургии соче-
танных заболеваний коронарных и магистральных артерий НЦ ССХ им. А.Н. Бакулева
Адрес: 119049, Москва, Ленинский пр-т, д. 8, к. 7, тел.: +7 (499) 236-92-53

Россия

References

  1. Nakamura S., Colombo A., Gaglione S., Almagor Y., Goldberg S.L. Intracoronary ultrasound observations during stent implantation. Circulation. 1994; 89: 2026–2034.
  2. Safian R.D., Freed M.S. The manual of interventional cardiology. 3rd edn. Physicians Press. 2001. 1029 р.
  3. Hoffmann R., Mintz G.S. Coronary instent restenosis — predictors, treatment and prevention. Eur. Heart. J. 2000; 21: 1739–1749.
  4. Mann J. Epidemiology and pathophysiology of coronary artery disease. Practical interventional cardiology. Mosby. 1997. P. 1–9.
  5. Kern M. Basic coronary balloon angioplasty and stenting. The Interventional Cardiac Catheterization Handbook. NY: Elsevier Inc. 2004. Р. 11–72.
  6. Silber S., Albertsson P., Avilés F.F., Camici P.G., Colombo A., Hamm C., Jorgensen E., Marco J., Nordrehaug J.E., Ruzyllo W., Urban P., Stone G.W., Wijns W. Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology. Eur. Heart J. 2005; 26: 804–847.
  7. Smith S., Dove J.T., Jakobs A.K. ACC/AHA Guidelines for Percutaneous Coronary Intervention (Revision of the 1993 PTC A Guidelines). J. Am. Coll. Cardiol. 2001; 37: 2239 I–22391 XVI.
  8. Smith S. Dove J.T., Jakobs A.K. ACC/AHA Guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines) executive summary: a report of the American College of Cardiology. American Heart Association task force on practice guidelines (Committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty) endorsed by the Society for Cardiac Angiography and Interventions. Circulation. 2001; 103: 3019–3041.
  9. Shubair M., Prabhakaran P., Pavlova V., Velianou J.L., Sharma A.M., Natarajan M.K. The relationship of body mass index to outcomes after percutaneous coronary intervention. J. Interv. Cardiol. 2006; 19 (5): 388–395.
  10. Abizaid A., Costa M.A., Blanchard D., Albertal M., Eltchaninoff H. Sirolimus–Eluting Stents Inhibit Neointimal Hyperplasia in Diabetic Patients. Insights from the RAVEL Trial. Eur. Heart J. 2004; 25: 107–112.
  11. Serruys P., Ong A.T., van Herwerden L.A., Sousa J.E., Jatene A., Bonnier J.J., Schönberger J.P., Buller N., Bonser R., Disco C., Backx B., Hugenholtz P.G., Firth B.G., Unger F. Five year outcomes after coronary stenting versus bypass surgery for the treatment of multivessel disease. The final analysis of the Arterial Revascularization Therapies Study (ARTS) randomized trial. J. Am. Coll. Cardiol. 2005; 46: 575–581.
  12. Colombo A. 12-month clinical follow-up of the TAXUS II paclitaxel eluting stent study ACC–2003. URL: http://www. medscape.com/viewarticle/451913 (available: 02.04.2015).
  13. Grube E., Silber S, Hauptmann K. et al. TAXUS I: six- and twelvemonth results from a randomized, double-blind. Trial on a slow-release paclitaxel-eluting stent for de novo coronary lesions. Circulation. 2003; 107: 38–42.
  14. Stables R. Coronary artery bypass surgery versus percutaneous coronary intervention with stent implantation in patients with multivessel coronary artery disease (the Stent or Surgery trial): a randomized controlled trial. Lancet. 2002; 360: 695–670.
  15. Morice M., Serruys P.W., Sousa J.E., Fajadet J., Hayashi В.E., Perin M., Colombo A., Schuler G., Barragan P., Guagliumi G., Molnàr F., Falotico R. A randomized comparison of a sirolimus eluting stent with a standard stent for coronary revascularization. N. Engl. J. Med. 2002; 346: 1773–1780.
  16. Douglas Р.S, Brennan J.M., Anstrom K.J., Sedrakyan A., Eisen-stein E.L., Haque G. Clinical Effectiveness of Coronary Stents in Elderly Persons Results From 262,700 Medicare Patients in the American College of Cardiology–National Cardiovascular Data Registry. J. Am. Coll. Cardiol. 2009; 53: 1629–1641.
  17. Groeneveld P.W., Matta M.A., Greenhut A.P., Yang F. Drug eluting compared with bare metal coronary stents among elderly patients. J. Am. Coll. Cardiol. 2008; 51: 2017–2024.
  18. Stettler C., Wandel S., Allemann S., Kastrati A., Morice M.C., Schömig A., Pfisterer M.E., Stone G.W., Leon M.B., de Lezo J.S., Goy J.J., Park S.J., Sabaté M., Suttorp M.J., Kelbaek H., Spaulding C., Menichelli M., Vermeersch P., Dirksen M.T., Cervinka P., Petronio A.S., Nordmann A.J., Diem P., Meier B., Zwahlen M., Reichenbach S., Trelle S., Windecker S., Jüni P. Outcomes associated with drug eluting аnd bare metal stents: a collaborative network meta-analysis. Lancet. 2007; 370: 937–948.
  19. Rao S., Shaw R.E., Brindis R.G., Klein L.W., Weintraub W.S., Krone R.J., Peterson E.D. Patterns and outcomes of drug eluting coronary stent use in clinical practice. Am. Heart. J. 2006; 152: 321–326.
  20. Lagerqvist B., James S.K., Stenestrand U. Lindbäck J., Nilsson T., Wallentin L. Long term outcomes with drug eluting stents versus bare metal stents in Sweden. N. Engl. J. Med. 2007; 356: 1009–1019.
  21. Kaiser C., Brunner-La Rocca H.P., Buser P.T., Bonetti P.O., Osswald S., Linka A., Bernheim A., Zutter A., Zellweger M., Grize L., Pfisterer M.E. Incremental cost effectiveness of drug eluting stents compared with a third generation bare-metal stent in a real world setting: randomized The Basel Stent Cost-Effectiveness Trial (BASKET). Lancet. 2005; 366: 921–929.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2015 "Paediatrician" Publishers LLC



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies