Effect of diabetes mellitus on outcome after percutaneous transluminal coronary angioplasty

Coronary Artery Disease

Volumn 7, Issue 10, 1996, Pages 744-752

  St Claire Jr , Donald A ^a   King III, Spencer B ^a,b  

^a EMORY UNIVERSITY   (United States)

^b EMORY UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

coronary artery disease; directional coronary atherectomy; ischemic heart disease; percutaneous transluminal coronary angioplasty

Indexed keywords

ATHERECTOMY; CLINICAL TRIAL; CORONARY ARTERY BYPASS GRAFT; CORONARY ARTERY DISEASE; CORONARY ARTERY OBSTRUCTION; DIABETES MELLITUS; HUMAN; ISCHEMIC HEART DISEASE; PRIORITY JOURNAL; REVIEW; TRANSLUMINAL CORONARY ANGIOPLASTY; TREATMENT OUTCOME;

EID: 8044256505     PISSN: 09546928     EISSN: None     Source Type: Journal    
DOI: 10.1097/00019501-199610000-00007     Document Type: Review

References (75)

1. Olefsky JM: Diabetes Mellitus. In Cecil Textbook of Medicine. Edited by Wyngaarden JB, Smith LH Jr. Philadelphia: WB Saunders Company; 1985:1320-1341.
2. Alderman EL, Corley SD, Fisher LD, Chaitman BR, Faxon DP, Foster ED, et al.: Five-year angiographic follow-up of factors associated with progression of coronary artery disease in the coronary artery surgery study (CASS). J Am Coll Cardiol 1993, 22:1141-1154.
3. Garcia MJ, McNamara PM, Gordon T, Kannell WB: Morbidity and mortality in diabetes in the Framingham population. Sixteen year follow-up study. Diabetes 1974, 23:105-111. A landmark epidemiological study demonstrating the independent contribution of diabetes mellitus to increased cardiovascular morbidity and mortality.
4. Stein B, Weintraub WS, Gebhart SSP, Cohen-Bernstein CL, Grosswald R, Liberman HA, et al.: Influence of diabetes mellitus on early and late outcome after percutaneous transluminal coronary angioplasty. Circulation 1995, 91:979-989. The first study to define the long-term clinical outcome after PTCA for a large cohort of patients with diabetes mellitus. In-hospital correlates of acute procedural outcome are also evaluated. The discussion section includes a thorough review of possible pathophysiologic mechanisms.
5. Lawrie GM, Morris GC Jr, Glaeser DH: Influence of diabetes mellitus on the results of coronary bypass surgery. JAMA 1986, 256:2967-2971.
6. Benchimol D, Benchimol H, Bonnet J, Dartigues JF, Couffinhal T, Bricaud H: Risk factors for progression of atherosclerosis six months after balloon angioplasty of coronary stenosis. Am J Cardiol 1990, 65:980-985.
7. Salomon NW, Page US, Okies EJ, Stephens J, Krause AH, Bigelow JC: Diabetes mellitus and coronary artery bypass. J Thorac Cardiovasc Surg 1983, 85:264-271. 12-year follow-up of 3707 patients, including 412 with diabetes mellitus, demonstrating a greater severity of coronary artery disease in diabetic patients with decreased long-term survival and cardiac-event-free survival.
8. Wilson CS, Gau GT, Fulton RE, Davis GD: Coronary artery disease in diabetic and non-diabetic patients: a clinical and angiographic comparison. Clin Cardiol 1983, 6:440-446.
9. Vigorito C, Betocchi S, Bonzani G, Giudice P, Miceli D, Piscione F, et al.: Severity of coronary artery disease in patients with diabetes mellitus: angiographic study of 34 diabetic and 120 non-diabetic patients. Am Heart J 1980, 100:782-787.
10. Hamby RI, Sherman L, Mehta J, Aintablian A: Reappraisal of the role of the diabetic state in coronary artery disease. Chest 1976, 70:251-257.
11. Dortimer AC, Schenoy PN, Shiroff PA, Leaman DM, Babb JD, Liedtke AI, et al.: Diffuse coronary artery disease in diabetic patients: fact or fiction? Circulation 1978, 57:133-136.
12. Zurich SW, Nesto RW: Diabetic cardiomyopathy. Am Heart J 1989, 118:1000-1012.
13. Ryan TJ, Bauman WB, Kennedy JW, Kereiakes DJ, King SB III, McCallister BD, et al.: Guidelines for percutaneous transluminal coronary angioplasty. J Am Coll Cardiol 1993, 22:2033-2054.
14. The Bypass Angioplasty Revascularization Investigation (BARI) Investigators: Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. N Engl J Med 1996, 335:217-225. This is the single largest randomized trial of CABG compared with PTCA for multivessel coronary artery disease. While there was no statistically significant difference in five-year survival between PTCA and CABG for the study group as a whole, subgroup analysis showed a highly significant survival benefit for diabetic patients initially randomized to CABG.
15. Moliterno DJ, Elliott JM, Topol EJ: Randomized trials of myocardial revascularization. Curr Probl Cardiol 1995, 20:121-192. A comprehensive review of the literature pertaining to randomized trials of coronary revascularization. Included are all trials of medical therapy versus CABG, medical therapy versus PTCA, PTCA versus CABG, and PTCA versus new-device therapy.
16. Ellis SG, Vandormael MG, Cowley MJ, DiSciascio G, Deligonul U, Topol EJ, et al.: Coronary morphologic and clinical determinants of procedural outcome with angioplasty for multivessel coronary disease. Implications for patient selection. Circulation 1990, 82:1193-1202.
17. Savage MP, Goldberg S, Hirshfeld JW, Bass TA, MacDonald RG, Margolis JR, et al.: Clinical and angiographic determinants of primary coronary angioplasty success. J Am Coll Cardiol 1991, 17:22-28.
18. Ellis SG, Roubin GS, King SB III, Douglas JS Jr, Shaw RE, Stertzer SH, et al.: In-hospital cardiac mortality after acute closure after coronary angioplasty: analysis of risk factors from 8207 procedures. J Am Coll Cardiol 1988, 11:211-216. A large retrospective study from two highly experienced institutions demonstrating no increased risk of acute closure after PTCA in diabetic patients. However, a substantially higher mortality associated with abrupt closure is noted in the diabetic population.
19. King SB III: Prediction of acute closure in percutaneous transluminal coronary angioplasty. Circulation 1990, 81 (suppl IV):IV5-IV8.
20. Detre K, Holubkov R, Kelsey S, Cowley M, Kent K, Williams D, et al.: Percutaneous transluminal coronary angioplasty in 1985-86 and 1977-81. The National Heart, Lung, and Blood Institute Registry. N Engl J Med 1988, 318:265-270.
21. Kimmel SE, Berlin JA, Strom BL, Laskey WK: Development and validation of a simplified predictive index for major complications in contemporary percutaneous transluminal coronary angioplasty practice. J Am Coll Cardiol 1995, 26:931-938.
22. Ellis SG, Cowley MJ, Whitlow PL, Vandormael M, Lincoff AM, DiSciascio G, et al.: Prospective case-control comparison of percutaneous transluminal coronary revascularization in patients with multivessel disease treated in 1986-1987 versus 1991: improved in-hospital and 12-month results. J Am Coll Cardiol 1995, 25:1137-1142.
23. Crall FV Jr, Roberts WC: The extramural and intramural coronary arteries in juvenile diabetes mellitus. Am J Med 1978, 64:221-230.
24. Davi G, Catalano I, Averna M, Notarbartolo A, Strano A, Ciabattoni G, Patrono C: Thromboxane biosynthesis and platelet function in type II diabetes mellitus. N Engl J Med 1990, 322:1769-1774.
25. Sagel J, Colwell JA, Crook L, Laimins M: Increased platelet aggregation in early diabetes mellitus. Ann Intern Med 1975, 82:733-738.
26. Schneider DJ, Nordt TK, Sobel BE: Attenuated fibrinolysis and accelerated atherogenesis in type II diabetic patients. Diabetes 1993, 42:1-7.
27. Aimer L, Pandolfi M: Fibrinolysis and diabetic retinopathy. Diabetes 1976, 25 (suppl 2):807-810.
28. Califf RM, Fortin DF, Frid DJ, Harlan WR, Ohman EM, Bengtson JR, et al.: Restenosis after coronary angioplasty: an overview. J Am Coll Cardiol 1991, 17 (suppl B):2B-13B. A comprehensive review of restenosis, including a discussion of pathophysiologic mechanisms, risk factors, clinical trials, and limitations of previous studies.
29. Hollman J, Badhwar K, Beck GJ, Franco I, Simpfendorfer C: Risk factors for recurrent stenosis following successful coronary angioplasty. Cleve Clin J Med 1989, 56:517-523.
30. Holmes DR, Vlietstra RE, Smith HC, Vetrovec GW, Kent KM, Cowley MJ, et al.: Restenosis after percutaneous transluminal coronary angioplasty (PTCA): a report from the PTCA registry of the National Heart, Lung, and Blood Institute. Am J Cardiol 1984, 53:77C-81C. The first large study to document the vexing problem of restenosis after PTCA. A higher rate of restenosis is demonstrated in diabetic patients.
31. Weintraub WS, Kosinski AS, Brown CL III, King SB III: Can restenosis after coronary angioplasty be predicted from clinical variables? J Am Coll Cardiol 1993, 21:6-14. An important study which defines diabetes mellitus and several other clinical variables as risk factors for restenosis. However, a model developed to predict prospectively the likelihood of restenosis in an individual patient is found to be unreliable.
32. Vandormael MG, Deligonul U, Kern MJ, Harper M, Presant S, Gibson P, et al.: Multilesion coronary angioplasty: clinical and angiographic follow-up. J Am Coll Cardiol 1987, 10:246-252.
33. Quigley PJ, Hlatky MA, Hinohara T, Rendall DS, Perez JA, Phillips HR, et al.: Repeat percutaneous transluminal coronary angioplasty and predictors of recurrent stenosis. Am J Cardiol 1989, 63:409-413.
34. Myler RK, Topol EJ, Shaw RE, Stertzer SH, Clark DA, Fishman J, Murphy MC, et al.: Multiple vessel coronary angioplasty: classification, results, and patterns of restenosis in 494 consecutive patients. Cathet Cardiovasc Diagn 1987, 13:1-15.
35. Lambert M, Bonan R, Cote G, Crepeau J, de Guise P, Lespérance J, et al.: Multiple coronary angioplasty: a model to discriminate systemic and procedural factors related to restenosis. J Am Coll Cardiol 1988, 12:310-314.
36. Hinohara T, Robertson GC, Selmon MR, Vetter JW, Rowe MH, Braden LJ, et al.: Restenosis after directional coronary atherectomy. J Am Coll Cardiol 1992, 20:623-632.
37. Fishman RF, Kuntz RE, Carrozza JP, Miller MJ, Senerchia CC, Schnitt SI, et al.: Long-term results of directional coronary atherectomy: predictors of restenosis. J Am Coll Cardiol 1992, 20:1101-1110.
38. Warth DC, Leon MB, O'Neill W, Zacca N, Polissar NL, Buchbinder M: Rotational Atherectomy Multicenter Registry: acute results, complications and 6-month angiographic follow-up in 709 patients. J Am Coll Cardiol 1994, 24:641-648.
39. Rabbani LE, Edelman ER, Ganz P, Selwyn AP, Loscalzo J, Bittl JA: Relation of restenosis after excimer laser angioplasty to fasting insulin levels. Am J Cardiol 1994, 73:323-327.
40. Moscucci M, Piana RN, Kuntz RE, Kugelmass AD, Carrozza JP, Senerchia CC, et al.: Effect of prior coronary restenosis on the risk of subsequent restenosis after stent placement or directional atherectomy. Am J Cardiol 1994, 73:1147-1153.
41. Carrozza JP, Kuntz RE, Levine MJ, Pomerantz RM, Fishman RF, Mansour M, et al.: Angiographic and clinical outcome of intracoronary stenting: immediate and long-term results from a large single-center experience. J Am Coll Cardiol 1992, 20:328-337.
42. Wong SC, Baim DS, Schatz RA, Teirstein PS, King SB III, Curry RC, et al.: Immediate results and late outcomes after stent implantation in saphenous vein graft lesions: the multicenter US Palmaz-Schatz stent experience. J Am Coll Cardiol 1995, 26:704-712.
43. Ellis SG, Savage M, Fischman D, Baim DS, Leon M, Goldberg S, et al.: Restenosis after placement of Palmaz-Schatz stents in native coronary arteries. Initial results of a multicenter experience. Circulation 1992, 86:1836-1844.
44. Carrozza JP Jr, Kuntz RE, Fishman RF, Baim DS: Restenosis after arterial injury caused by coronary stenting in patients with diabetes mellitus. Ann Intern Med 1993, 118:344-349. This single-center study of coronary stenting clearly delineates the greater predisposition to intimal hyperplasia in diabetic patients. The novel characteristics of the intracoronary stent eliminate recoil and vasospasm, allowing an isolated analysis in vivo of the contribution of intimal smooth muscle cell hyperplasia.
45. Fischman DL, Leon MB, Baim DS, Schatz RA, Savage MP, Penn J, et al.: A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med 1994, 331:496-501.
46. Serruys PW, de Jaegere P, Kiemeniej F, Macaya C, Rutsch W, Heyndrickx G, et al.: A comparison of balloon-expandable stent implantation with balloon angioplasty in patients with coronary artery disease. N Engl J Med 1994, 331:489-495.
47. Forrester JS, Fishbein M, Helfant R, Fagin J: A paradigm for restenosis based on cell biology: clues for the development of new preventive therapies. J Am Coll Cardiol 1991, 17:758-769. A comprehensive and scholarly review of the pathobiology of restenosis, including its time course, histopathologic characteristics and relation to atherogenesis and wound healing. Extremely well referenced.
48. Kuntz RE, Gibson CM, Nobuyoshi M, Baim DS: Generalized model of restenosis after conventional balloon angioplasty, stenting and directional atherectomy. J Am Coll Cardiol 1993, 21:15-25.
49. Ledet T, Fischer Dzoga K, Wissler RW: Growth and rabbit aortic smooth-muscle cell cultured in media containing diabetic and hyperlipemic serum. Diabetes 1976, 25:207-215.
50. Banskota NK, Taub R, Zellner K, Olsen P, King GL: Characterization of induction of protooncogene c-myc and cellular growth in human vascular smooth muscle cells by insulin and IGF-I. Diabetes 1989, 38:123-129.
51. Liu MW, Roubin GS, King SB III: Restenosis after coronary angioplasty. Potential biologic determinants and role of intimal hyperplasia. Circulation 1989, 79:1374-1387.
52. Barbano EF, Newman GE, McCann RL, Hakel DB, Stack RS, Palmos LE, et al.: Correlation of clinical history with quantitative histology of lower extremity atheroma biopsies obtained with the Simpson atherectomy catheter. Arteriosclerosis 1989, 78:183-196.
53. Aronson D, Bloomgarden Z, Rayfield EJ: Potential mechanisms promoting restenosis in diabetic patients. J Am Coll Cardiol 1996, 27:528-535.
54. Emond M, Mock MB, Davis KB, Fisher LD, Holmes DR Jr, Chaitman BR, et al.: Long-term survival of medically treated patients in the coronary artery surgery study (CASS) registry. Circulation 1994, 90:2645-2657. An important study defining the natural history of medically treated patients with coronary artery disease. Clinical, angiographic and demographic characteristics associated with decreased survival are identified, including diabetes mellitus.
55. Smith LR, Harrell FE, Rankin JS, Califf RM, Pryor DB, Muhlbaier LH, et al.: Determinants of early versus late cardiac death in patients undergoing coronary artery bypass graft surgery. Circulation 1991, 85 (suppl III):III245-III253.
56. Morris JJ, Smith LR, Jones RH, Glower DD, Morris PB, Muhlbaier LH, et al.: Influence of diabetes and mammary artery grafting on survival after coronary bypass. Circulation 1991, 84 (suppl III):III275-III284. This study from Duke University Medical Center established the independent risk of diabetes mellitus for late cardiac mortality after coronary bypass surgery in the era of internal mammary artery grafting. Data were analyzed from 5654 consecutive patients, 1132 of whom had diabetes, with 5-8 year follow-up.
57. Weintraub WS, Jones EL, Craver JM, Grosswald R, Guyton RA: In-hospital and long-term outcome after reoperative coronary artery bypass graft surgery. Circulation 1995, 92 (suppl II):II50-II57.
58. French JK, Scott DS, Whitlock RML, Nisbet HD, Vedder M, Kerr AR, et al.: Late outcome after coronary artery bypass graft surgery in patients < 40 years old. Circulation 1995, 92 (suppl II):II14-II19.
59. Weintraub WS, Ghazzal ZMB, Douglas JS Jr, Liberman HA, Morris DC, Cohen CL, King SB III: Long-term clinical follow-up in patients with angiographic restudy after successful angioplasty. Circulation 1993, 87:831-840.
60. Weintraub WS, Ghazzal ZMB, Cohen CL, Douglas JS Jr, Liberman HA, Morris DC, King SB III: Clinical implications of late proven patency after successful coronary angioplasty. Circulation 1991, 84:572-582. Diabetes is established as an independent correlate of late cardiac events after PTCA, despite documented treatment-site patency up to 1 year after the procedure. Diabetes as a risk factor or marker for diffuse disease and more rapid progression of atherosclerosis is discussed, and the importance of complete revascularization is emphasized.
61. Mick MJ, Piedmonte MR, Arnold AM, Simpfendorfer C: Risk stratification for long-term outcome after elective coronary angioplasty: a multivariate analysis of 5000 patients. J Am Coll Cardiol 1994, 24:74-80.
62. Gruentzig AR, King SB III, Schlumpf M, Siegenthaler W: Long-term follow-up after percutaneous transluminal coronary angioplasty. The early Zurich experience. N Engl J Med 1987, 316:1127-1132.
63. Faxon DP, Ruocco N, Jacobs AK: Long-term outcome of patients after percutaneous transluminal coronary angioplasty. Circulation 1990, 81 (suppl IV):IV9-IV13.
64. Ellis SG, Cowley MJ, DiSciascio G, Deligonul U, Topol EJ, Bulle TM, et al.: Determinants of 2-year outcome after coronary angioplasty in patients with multivessel disease on the basis of comprehensive preprocedural evaluation. Implications for patient selection. Circulation 1991, 83:1905-1914. This study evaluates 31 clinical and angiographic variables in patients undergoing multivessel PTCA and identifies four characteristics, one of which is diabetes, that are associated with a substantially decreased likelihood of event-free survival. A treatment strategy for patients with multivessel disease based on these variables is proposed.
65. Nobuyoshi M, Kimura T, Nosaka H, Mioka S, Ueno K, Yokoi H, et al.: Restenosis after successful percutaneous transluminal coronary angioplasty: serial angiographic follow-up of 229 patients. J Am Coll Cardiol 1988, 616:616-623.
66. Samson M, Meester HJ, De Feyter PJ, Strauss B, Serruys PW: Successful multiple segment coronary angioplasty: effect of completeness of revascularization in single-vessel multilesions and multivessels. Am Heart J 1990, 120:1-12.
67. Parisi AF, Folland ED, Hartigan P, on behalf of the Veterans Affairs ACME Investigators: A comparison of angioplasty with medical therapy in the treatment of single-vessel coronary artery disease. N Engl J Med 1992, 326:10-16.
68. Pocock SJ, Henderson RA, Rickards AF, Hampton JR, King SB III, Hamm CW, et al.: Meta-analysis of randomized trials comparing coronary angioplasty with bypass surgery. Lancet 1995, 346:1184-1189. Although no specific conclusions regarding patients with diabetes are discussed in this paper, the cumulative evidence of all randomized trials comparing PTCA with CABG are analyzed and show no difference in prognosis between the two initial strategies.
69. Hueb WA, Bellotti G, Almeida de Oliveira S, Arie S, Piva de Albuquerqe C, Jatene AD, Pileggi E: The Medicine, Angioplasty or Surgery Study (MASS): a prospective randomized trial of medical therapy, balloon angioplasty or bypass surgery for single proximal left anterior descending artery stenoses. J Am Coll Cardiol 1995, 26:1600-1605.
70. CABRI Trial Participants: First-year results of CABRI (Coronary Angioplasty versus Bypass Revascularization Investigation). Lancet 1995, 346:1179-1184.
71. Rodriguez A, Boullon F, Perez-Balino N, Paviotti C, Sosa Liprandi MI, Palacios JF, on behalf of the ERACI group: Argentine randomized trial of percutaneous transluminal coronary angioplasty versus coronary artery bypass surgery in multivessel disease (ERACI): in-hospital results and 1-year follow-up. J Am Coll Cardiol 1993, 22:1060-1067.
72. Goy JJ, Eeckhout E, Burnand B, Vogt P, Stauffer JC, Hurni M, et al.: Coronary angioplasty versus left internal mammary artery grafting for isolated proximal left anterior descending artery stenosis. Lancet 1994, 343:1449-1453.
73. RITA Trial Participants: Coronary angioplasty versus coronary artery bypass surgery: the Randomized Intervention Treatment of Angina (RITA) trial. Lancet 1993, 341:573-580.
74. King SB III, Lembo NJ, Weintraub WS, Kosinski AS, Barnhart HX, Kutner MH, et al.: A randomized trial comparing coronary angioplasty with coronary bypass surgery. N Engl J Med 1994, 331:1044-1050.
75. Hamm CW, Reimers J, Ischinger T, Rupprecht HJ, Berger J, Bleifeld W for the German Angioplasty Bypass Surgery Investigation: A randomized study of coronary angioplasty compared with bypass surgery in patients with symptomatic multivessel coronary disease. N Engl J Med 1994, 331:1037-1043.