Impact of diabetes mellitus on outcome of patients undergoing carotid artery stenting: insights from a single center registry

Catheter Cardiovasc Interv. 2007 Mar 1;69(4):541-5. doi: 10.1002/ccd.21020.

Abstract

Objective: To evaluate the impact of diabetic status on outcome of patients undergoing carotid artery stenting (CAS).

Background: Diabetes has been demonstrated to be a strong predictor of adverse outcome in patients undergoing coronary revascularization. Its significance in predicting outcome of patients undergoing carotid interventions has not been ascertained.

Methods: We evaluated the short-term outcomes of 833 patients who underwent CAS at our institution. The primary outcome of this analysis was 30 day incidence of stroke, myocardial infarction, and death.

Results: Diabetes was present in 311 patients. Baseline characteristics were comparable between diabetics and nondiabetics except for the diabetics having a lower left ventricular ejection fraction, lower hemoglobin, and a higher body mass index at baseline. Further, they were more likely to have congestive heart failure and coronary artery disease. There was no difference in the incidence of stroke (1.9% versus 2.7%,), myocardial infarction (MI) (2.6% versus 1.9%), death (3.9% versus 2.5%), or the composite of death stroke or MI (6.8% versus 5.9%) at 30 days between diabetics and nondiabetics. Similar results were seen when the analysis was restricted to patients treated with an emboli protection device. Diabetes was not a risk factor for adverse outcome after CAS after multivariate adjustment.

Conclusion: Diabetics undergoing CAS are more likely to have associated co-morbidities. However despite this handicap, their short term outcome after CAS is similar to that of nondiabetics.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Vessel Prosthesis Implantation / adverse effects*
  • Blood Vessel Prosthesis Implantation / mortality
  • Carotid Artery Diseases / surgery*
  • Carotid Artery, Common / surgery*
  • Case-Control Studies
  • Diabetes Complications* / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / etiology
  • Myocardial Infarction / mortality
  • Ohio
  • Predictive Value of Tests
  • Registries
  • Regression Analysis
  • Research Design
  • Risk Factors
  • Stents / adverse effects*
  • Stroke / epidemiology*
  • Stroke / etiology
  • Stroke / mortality
  • Survival Analysis
  • Time Factors
  • Treatment Outcome