Clinical Outcome of Patients with Diabetes Mellitus and Chronic Total Occlusion Treated with Drug-Eluting Stents

Objectives The prognosis of patients with chronic total occlusion (CTO) and diabetes mellitus treated with percutaneous coronary intervention (PCI) and drug eluting stent (DES) implantation is unknown Methods We compared the 12 month outcomes of 52 diabetic patients with CTO after successful PCI who underwent DES implantation with that of 47 patients with diabetes and CTO previously treated with bare metal stents (BMS) Death, myocardial infarction and repeat PC I or coronary artery bypass surgery were considered as a combined primary endpoint Results At 1 year follow up the primary endpoint occurred in 6% (n = 3) of patients treated with DES and 23% (n = 11) of the patients treated with BMS (p = 0 01) One patient in the DES group and 3 patients in the BMS group died during follow up (p = 0 26) Stepwise logistic regression analysis identified DES (odds ratio [OR] = 12 9 95% confidence Interval [CI] 2 90-57 5 p = 0 0004) and final minimal lumen diameter (odds ratio [OR] = 10 1 95% CI 1 81-56 4 p = 0 01) as Independent correlates of major adverse cardiac events (MACE) at follow up Conclusions In patients with chronic total occlusion DES were superior to bare metal stents in reducing the MACE and should be considered a preferred treatment stratergy for patients with diabetes and CTO undergoing PCI