Interventional treatment in diabetics in the era of drugeluting stents and compliance to the ESC guidelines: Lessons learned from the Euro Heart Survey Programme

Yoshinobu Onuma, Neville Kukreja, Steve Ramcharitar, Matthias Hochadel, Anselm Gitt, Patrick Serruys, Jean Marco, Alec Vahanian, Franz Weidinger, William Wijns, Uwe Zeymer, Sigmund Silber, Ricardo Seabra-Gomez, Franz Eberli, Malika Manini, Claire Bramley, Valerie Laforest, Charles Taylor, Kurt Huber, Guy De BackerVera Sirakova, Roman Cerbak, Per Thayssen, Osama Abdel Aziz, Khalid Tammam, Seppo Lehto, François Delahaye, Bondo Kobulia, Uwe Zeymer, Dennis Cokkinos, Dimitrios Kremastinos, Kristof Karlocai, Emer Shelley, Shlomo Behar, Aldo Maggioni, Virginija Grabauskiene, Jaap Deckers, Inger Asmussen, Janina Stepinska, Lino Gonçalves, Candida Fonseca, Vyacheslav Mareev, Zorana Vasilijevic, Montenegro Igor Riecansky, Miran F. Kenda, Jose Luis Lopez-Sendon, Annika Rosengren, Peter Buser, Tugrul Okay, Oleg Sychov, Peter Schofield, A. K. Gitt, L. Tavazzi, R. Seabra Gomes, J. Marrugat de la Iglesia, L. Wallentin, P. Kearney, K. McGregor, M. L. Simoons, Bristol Myers Squibb, Eli Lilly, Kristine Margaryan, Shahen Khachatryan, Franz Weidinger, Jakob Doerler, Eva Maria Stocker, Innsbruck Johann Altenberger, Matthias Heigert, Max Pichler, Salzburg Gunther Christ, Helmut Glogar, Irene Lang, Stefan Ingerle, Philip De Wilde, Michel de Marneffe, Bruxelles M. Vrolix, Joseph Dens, Johan Van Lierde, Genk X. De Wagter, Gent Marc Carlier, Gilly Antoon Weyne, Kortrijk Victor Legrand, Pierre Doneux, Olivier Gach, Laurent Davin, Liège Eric Mievis, Pierre Emmanuel Massart, Namur G. Holvoet, Lovel Giunio, Duska Glavas, Ivica Vukovic, Branimir Markovic, Darko Duplancic, F. Runjic, Spilt Edvard Galic, Jure Mirat, Petr Kala, Jiri Semenka, Ota Hlinomaz, Erik Petrikovits, Brno Petr Widimsky, Petr Tousek, Prague Ivo Varvarovsky, P. Thayssen, Helle Cappelen, Odense Steffen Helqvist, Henning Kelbaek, Erik Jorgensen, T. Engstrom, Kari Saunamaki, Jens Kastrup, Peter Clemmensen, H. Hansen, Magid Al Abbadi, Khalid Tammam, Hany Abdel Razek, Gamal Aboul el Nasr, Hany Ragi, Basam Ibrihim, Basam Zarif, Naha el Banhawy, Khalid Sorour, Mohamed Abdel Meguid, Ahmed Mahrous, Khalid Ahmed Al Khashab, Fayoum Ahmed Abd Elmoniem, Metwaly El Emry, Amr El Naggar, Benha Aly Saad, Peep Laanmets, Jyri Voitk, Piia Lutter, Sigrid Jarvekulg, Mati Jalakas, Julia Reinmets, Toomas Marandi, Margus Peeba, Tarmo Serka, Mikko Syvannne, Esa Kaihovirta, Helsinki Kari Korpilahti, Mari Anne Vaittinen, Jean Pierre Bassand, Denis Pales Espinosa, Besancon Yves Cottin, Isabelle Lhuillier, Philippe Buffet, L. Lorgis, Dijon Jacques Machecourt, Bernard Bertrand, Delphine Serrano, Grenoble Jean Louis Bonnet, Marseille Philippe Gabriel Steg, Jean Michel Juliard, Reza Farnoud, Paris Nicolas Delarche, Pau Jean Marco, Frederic Petit, Bruno Farah, Didier Carrie, Michel Galinier, Jacques Puel, Jacqueline Cahuzac, Jerome Roncalli, Stephane Tauzin, Meyer Elbaz, Volker Schachinger, Frankfurt Anselm Gitt, Uwe Zeymer, Ludwigshafen am Rhein Ralf Zahn, Boris Fraiture, Siegberto Haetinger, Nurnberg H. Klepzig, E. Girth, A. Hauber, Offenbach Christian Firschke, Jochen Widmaier, Florian Hofbauer, Stefan Huttl, Pfaffenhofen Udo Sechtem, Ulli Parade, Stuttgart Georg Linnartz, D. Cokkinos, Stalikas Andrianidis, Natassa Tsiavou, Georgios Papaioannou, Efthymios Deliargyris, Maroussi Attikis, Dimitrios Alexopoulos, Periklis Davlouros, Dimitrios Tsikaderis, Petros Dardas, Nikolaos Mezilis, Edes Istvan, Bakos Zoltan, Yoav Turgeman, Suleiman Khaled, Alexander Feldman, Jamal Jafari, Iliya Manevich, Carlos Cafri, Reuben Ilia, Akram Abu-Ful, Sergei Yaroslavslev, Jean Mark Wainstain, Gabriel Rosenchtein, Beer Sheva, Ricardo Krakover, Beer Yakov, David Halon, Luis Gruberg, Walter Markiewicz, Ehud Grenadier, Monther Boulos, Ariel Roguin, Arthur Kerner, Shlomo Amikam, Margalit Ben-Tzvi, Jeremy Rezmovitz, Haifa Morris Mosseri, Haim Lotan, Boris Varshizky, Hisham Nassar, Haim Daninberg, David Rot, Tedi Vais, Jesaia Benhorin, Andre Keren, Aharon Medina, Zahi Huri, Jerusalem Simcha Brandis, Guy Schoenmann, Netanya Ran Kornowski, Abed Assali, Shmuel Fuch, David Hasdai, David Brosh, Offer Sela, Igal Teplitski, Petach Tikva, Oded Eisenberg, Shmuel Banai, Ariel Finkelstein, Yonathan Hasin, Muein Aboud, Menachem Nahir, Daud Qarwani, Genem Diab, Luigi Meloni, Giorgio Lai, M. Cadeddu, R. Pirisi, Francesco Bonechi, Franco Nassi, Massimiliano Nieri, Andrea Taiti, Alessandra Naldoni, Francesco Calabro, Felice Achilli, Stefano Maggiolini, Luigi Piatti, Gianluca Tiberti, Piero Addamiano, Sergio Berti, Marcello Ravani, Cataldo Palmieri, Giuseppe Trianni, Simona Cardullo, Angelo Cioppa, Paolo Rubino, Vittorio Ambrosini, L. Salemme, G. Sorropago, T. Tesorio, Giuseppe Geraci, Filippo Scalise, Simone Mazzeti, Carla Auguadro, Giovanni Esposito, Guido Canali, Maria Enrica Caccia, Chiara Ruggieri, Bertola Benedetta, Nicoletta de Cesare, M. De Benedictis, Tiziana Coco, Sabrina Manzotti, Osio Sotto Fraz, Paolo Marraccini, Alessandro Danesi, R. Ricci, A. Ferraironi, E. Olivieri, A. Chiera, Stefano Garducci, Daniela Grasseli, Peter Kearney, Eugene McFadden, Noel Cahill, Martin Quinn, Peter Crean, Eileen Caroll, David Foley, Stephen O'Connor, Rory O'Hanlon, Bernadette Lynch, Srah O'Donnell, James Roy, Darragh O'Brien, Asnate Krastina, Andrejs Erglis, Samih Lawand, Waldemar Dorniak, Jacek Klaudel, Krzysztof Pawlowski, Wojciech Trenkner, Marianna Janion, Marcin Sadowski, Agnieszka Janion-Sadowska, Izabella Skorupa, Leszek Bystryk, Adam Kern, Bartlomiej Janiak, Roman Szelemej, Witold Ruzyllo, Adam Witkowski, Tomasz Deptuch, Renata Maczynska-Mazuruk, Andrezj Budaj, Kokowicz Lewandowski Cegieska, Grzegorz Opolski, Joanna Wilczyska, Marek Roik, Janusz Kochman, Dinis Martins, Isabel Maria Fernandes Joao Goncalves, Helder Pereira, Henrique Faria, Joao Calisto, Lino Goncalves, Victor Matos, Antonio Leitao-Marques, M. Costa, H. Oliveira, P. Mota, Walter Santos, Victor Brandao, Faro Graca Caires, Bruno Silva, Funchal Rui Campante Teles, Manuel Almeida, Pedro Goncalves, Luis Raposo, Luis Mourao, Luis Bernardes, Paulo G. Pedro, Rui Ferreira, Rui Conduto, Jorge Quininha, Lino Patricio, Duarte Cacela, Jose Maria Goncalves, Lidia de Sousa, Manuela Adao, Lisbon Henrique Cyrne Carvalho, Helia Romeira, Jose Paulino Sousa, Jose Manuel Mota Garcia, J. Carlos Silva, Domingos Magalhaes, Porto Ricardo Santos, Setubal Pedro Gama Mendes, Joao Pipa, Luis Nunes, Pedro Ferreira, Dragos Vinereanu, Cristian Udroiu, Nicolae Florescu, Octavian Parvu, Claudiu Stoicescu, Maria Dorobantu, Serban Mihai Balanescu, Rodica Niculescu, Lucian Calmac, M. Marinescu, Bucharest Dan Olinic, Mihai Ober, Calin Homorodean, Claudia Budurea, Adrian Hij, Florin Anton, Cluj-Napoca, Florin Ortan, Ciprian Suciu, Mihai Ursu, Costica Baba, Targu-Mures, Stefan Iosif Dragulescu, Lucian Petrescu, Milovan Slovenski, Dan Gavrilescu, Cristian Dina, Bogdan Mut, Rade Babic, Mirko Colic, Dragan Topic, Joan Bassaganyas Vilarrasa, Marti Puigfel Pont, Rafael Masia Martorell, Izabella Rohlfs, Rafael Melgares Moreno, Maria Irurita, Juncal Irurita, Las Palmas de Gran Canaria, Carlos Escobar Cervantes, Teresa Galvan, Jimenez Navarro, Dominguez Franco, Ignacio Santos Rodriguez, Victor Hogo Ramirez, Francisco Fernandes-Aviles, Ana Revilla, Pedro Mota, Nicholas Masson, Virginie Dupertuis, Salem Kachboura, Atila Iyisoy, Mustafa Kemal Erol, Zeki Ongen, Erhan Babalik, Mehmet Oskan, Nihal Ozdemir, Ali Oto, Kudret Aytemir, Bunyemin Yavuz, Mahmut Sahin, Kenan Durna, Vedat Aytekin, Cemsit Demiroglu, Murat Gulbaran, Saide Aytekin, Alp Burak Catakoglu, Burak Ozme, Gokmen Gemici, Hasan Feray, P. M. Schofield, S. Kahn, S. Clarke, Heather Millington, Carlo Di Mario, Debra Dempster, Robert Anthony Henderson, Jane Burton, Della Falcon-Lang

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: The objective of the study is to determine the demographics and the in-hospital outcome of diabetic and non-diabetic patients treated with percutaneous coronary interventions (PCI) in Europe, to report the type of equipment and technology used for PCI procedures in diabetics and to clarify whether the treatment of diabetic patients complies with current European Society of Cardiology (ESC) guidelines. Methods and results: A total of 14,458 patients treated with PCI were enrolled from 29 member countries of the ESC between June 2005 and January 2006. Data were collected on patient characteristics and treatment, using new Cardiology Audit and Registration Data standards. In total, 3,603 patients (24.9%) were diabetic. Diabetics were older, more often female and had a higher body mass index than non-diabetics. Diabetics had higher rates of hypercholesterolaemia and hypertension, while current smokers were more frequent in the non-diabetics. Diabetics also had significantly higher rates of previous cardiovascular events. Clopidogrel was administered only in 48.1% of diabetic patients before PCI, while IIb/IIIa inhibitors were 22.9% during PCI. At discharge, there was a major adjustment of treatment with increases in the use of Beta-blocker (80.4%), angiotensin converting enzyme inhibitor (ACEI, 71.3%) and statins (89.8%) compared with on admission (Beta-blocker 60.9%, ACEI 55.0%, statin 63.1%). Inhospital mortality was higher in diabetics (1.8% vs 1.2%) although the in-hospital MACCE rate was not significantly different (3.6% vs 3.0%, p=0.09). Conclusions: Diabetic patients treated with PCI were older with more comorbidity. According to ESC guideline, the under-usage of clopidogrel, GP IIb/IIIa inhibitors should be improved. PCI is now taken as a good opportunity to adjust the use of appropriate medication.

Original languageEnglish
Pages (from-to)578-587
Number of pages10
JournalEuroIntervention
Volume4
Issue number5
DOIs
StatePublished - 1 Mar 2009

Keywords

  • Angioplasty
  • Diabetics
  • Drug eluting stent
  • European Heart Survey
  • Risk factors

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