Clinical impact of complete revascularization on real-life diabetic patients
ABSTRACT Introduction and objectives: The need for complete coronary artery revascularization after acute coronary syndrome in diabetic patients with multivessel coronary artery disease was discussed, even more so if they reflect the routine clinical practice (“real world”). Th...
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| Format: | Article |
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Permanyer
2022-11-01
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| Series: | REC: Interventional Cardiology (English Ed.) |
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| Online Access: | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=898 |
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| author | Fernando Puyol-Ruiz Eva M. Chueca-González Fernando Carrasco-Chinchilla José Luis López-Benítez Juan Horacio Alonso-Briales José María Melero-Tejedor José María Hernández-García Manuel Jiménez-Navarro |
| author_facet | Fernando Puyol-Ruiz Eva M. Chueca-González Fernando Carrasco-Chinchilla José Luis López-Benítez Juan Horacio Alonso-Briales José María Melero-Tejedor José María Hernández-García Manuel Jiménez-Navarro |
| author_sort | Fernando Puyol-Ruiz |
| collection | DOAJ |
| description | ABSTRACT Introduction and objectives: The need for complete coronary artery revascularization after acute coronary syndrome in diabetic patients with multivessel coronary artery disease was discussed, even more so if they reflect the routine clinical practice (“real world”). Therefore, the objective of this study is to analyze cardiovascular complications in diabetics with and without complete revascularization included in clinical trials and in the routine clinical practice. Methods: This was a single-center retrospective study of diabetic patients with multivessel coronary artery disease. We analyzed 733 diabetic patients: 299 (40.8%) with compatible criteria to be included in clinical trials, and 434 real-world patients (59.2%). Results: Real-world patients make up 59.2% of the sample. They are characterized by a higher percentage of risk factors, older mean age, and more comorbidities. Diabetics with multivessel coronary artery disease included in the trials have a lower risk of overall mortality (HR, 0.30; 95%CI, 0.16-0.57; P < .001), cardiac death (HR, 0.33; 95%CI, 0.15-0.71; P = .03), and major adverse cardiovascular events (HR, 0.58; 95%CI, 0.38-0.86; P = .008). On the other hand, receiving complete revascularization reduces the risk of cardiac death (HR, 0.32; 95%CI, 0.13-0.83; P = .019), and major adverse cardiovascular events (HR, 0.50; 95%CI, 0.29-0.89; P = .017) in real-world diabetic patients. Conclusions: It is suggested that fully revascularizing real-world patients would improve survival prognosis. In addition, diabetics included in clinical trials present fewer complications compared to those not included. |
| first_indexed | 2024-04-12T11:18:05Z |
| format | Article |
| id | doaj.art-a25983e328d24694b07d9b993358fed2 |
| institution | Directory Open Access Journal |
| issn | 2604-7322 |
| language | English |
| last_indexed | 2024-04-12T11:18:05Z |
| publishDate | 2022-11-01 |
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| record_format | Article |
| series | REC: Interventional Cardiology (English Ed.) |
| spelling | doaj.art-a25983e328d24694b07d9b993358fed22022-12-22T03:35:27ZengPermanyerREC: Interventional Cardiology (English Ed.)2604-73222022-11-014427127810.24875/RECICE.M22000308Clinical impact of complete revascularization on real-life diabetic patientsFernando Puyol-Ruiz0Eva M. Chueca-González1Fernando Carrasco-Chinchilla2José Luis López-Benítez3Juan Horacio Alonso-Briales4José María Melero-Tejedor5José María Hernández-García6Manuel Jiménez-Navarro7Facultad de Medicina, Universidad de Málaga, Málaga, SpainUnidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain. Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain. Departamento de Cardiología, Hospital Punta de Europa, Algeciras, Cádiz, SpainUnidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain. Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), SpainUnidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain. Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), SpainUnidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain. Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), SpainUnidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain. Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), SpainUnidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain. Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), SpainUnidad de Gestión Clínica del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain. Instituto Biosanitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), SpainABSTRACT Introduction and objectives: The need for complete coronary artery revascularization after acute coronary syndrome in diabetic patients with multivessel coronary artery disease was discussed, even more so if they reflect the routine clinical practice (“real world”). Therefore, the objective of this study is to analyze cardiovascular complications in diabetics with and without complete revascularization included in clinical trials and in the routine clinical practice. Methods: This was a single-center retrospective study of diabetic patients with multivessel coronary artery disease. We analyzed 733 diabetic patients: 299 (40.8%) with compatible criteria to be included in clinical trials, and 434 real-world patients (59.2%). Results: Real-world patients make up 59.2% of the sample. They are characterized by a higher percentage of risk factors, older mean age, and more comorbidities. Diabetics with multivessel coronary artery disease included in the trials have a lower risk of overall mortality (HR, 0.30; 95%CI, 0.16-0.57; P < .001), cardiac death (HR, 0.33; 95%CI, 0.15-0.71; P = .03), and major adverse cardiovascular events (HR, 0.58; 95%CI, 0.38-0.86; P = .008). On the other hand, receiving complete revascularization reduces the risk of cardiac death (HR, 0.32; 95%CI, 0.13-0.83; P = .019), and major adverse cardiovascular events (HR, 0.50; 95%CI, 0.29-0.89; P = .017) in real-world diabetic patients. Conclusions: It is suggested that fully revascularizing real-world patients would improve survival prognosis. In addition, diabetics included in clinical trials present fewer complications compared to those not included.https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=898Diabetes Revascularization Real world Multivessel coronary artery disease |
| spellingShingle | Fernando Puyol-Ruiz Eva M. Chueca-González Fernando Carrasco-Chinchilla José Luis López-Benítez Juan Horacio Alonso-Briales José María Melero-Tejedor José María Hernández-García Manuel Jiménez-Navarro Clinical impact of complete revascularization on real-life diabetic patients REC: Interventional Cardiology (English Ed.) Diabetes Revascularization Real world Multivessel coronary artery disease |
| title | Clinical impact of complete revascularization on real-life diabetic patients |
| title_full | Clinical impact of complete revascularization on real-life diabetic patients |
| title_fullStr | Clinical impact of complete revascularization on real-life diabetic patients |
| title_full_unstemmed | Clinical impact of complete revascularization on real-life diabetic patients |
| title_short | Clinical impact of complete revascularization on real-life diabetic patients |
| title_sort | clinical impact of complete revascularization on real life diabetic patients |
| topic | Diabetes Revascularization Real world Multivessel coronary artery disease |
| url | https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=898 |
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