Clinical and Angiographic Outcomes of Diabetic Patients After Coronary Stenting: A Comparison of Native Vessel Stent Restenosis Rates in Different Diabetic Subgroups

Abstract

The main objectives of this study were to analyze the relationship between stent restenosis and microalbuminuria, which may express not only the glomerular vessels damage but also widespread microvascular dysfunction including coronary arterial disease, and to determine the angiographic and clinical outcomes of different diabetic subgroups after coronary stenting. Identification of the factors that may predict the outcome after coronary stent placement in diabetic patients could assist in deciding different stenting strategies in different diabetic subgroups. Control coronary angiographies were performed in 136 diabetic patients 6 months after coronary stent implantation. Patients were divided into 3 subgroups according to their microalbuminuria status. Clinical and angiographic outcomes and distribu tion of various risk factors were determined for these subgroups. Blood pressure and serum cholesterol concentrations were higher in the overt diabetic nephropathy group. The mean diseased vessel segment rate was lower in patients without microalbuminuria. Although the mean stent length and size were similar, patients without microalbuminuria had lower restenosis rates (23.9% vs 53.2% [microalbuminuria] and 46.2% [overt diabetic nephropathy] p < 0.01). Insulin therapy or gender caused no difference in restenosis rate. Although stent lengths and diameters were not different, patients with microalbuminuria had higher restenosis rates. The authors suggest that microalbuminuria may be an independent risk factor for restenosis in patients with diabetes.