Su Nam Lee, Donggyu Moon, Sung-Ho Her, Won Young Jang, Keon-Woong Moon, Ki-Dong Yoo, Kyusup Lee, Jae Hwan Lee, Jang Hoon Lee, Sang Rok Lee, Seung-Whan Lee, Kyeong Ho Yun, Hyun-Jong Lee, Ik Jun Choi
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The diabetes group had a significantly higher frequency of multivessel disease; comorbidities such as hypertension, dyslipidemia, and chronic kidney disease; and lower ejection fraction of the left ventricle compared to the non-diabetes group (n=235). There were no significant differences in procedure success and complications observed between the two groups. Target vessel failure at 30 days between the diabetes and non-diabetes groups was not statistically significant in a multivariate Cox regression analysis (1.6% vs. 2.6%, adjusted hazard ratio [HR] 0.595, 95% confidence interval [CI] 0.154-2.300, <i>P</i>=.451). During an 18-month follow-up, the risk of target vessel failure was higher (12.5% vs. 8.9%) but the difference was not statistically significant (adjusted HR 1.393, 95% CI 0.782-2.482, <i>P</i>=.260).</p><p><strong>Conclusions: </strong>Patients with diabetes have a risk of complications comparable to patients without diabetes, and 30-day and 18-month clinical outcomes are similar in severe coronary artery calcification requiring RA, despite having more comorbidities.</p><p><strong>Limitations: </strong>Retrospective design. Sample size not based on power calculation.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/65/0256-4947.2022.291.PMC9557786.pdf","citationCount":"1","resultStr":"{\"title\":\"Impact of diabetes mellitus on periprocedural and 18-month clinical outcomes in Korean patients requiring rotational atherectomy: results from the ROCK Registry.\",\"authors\":\"Su Nam Lee, Donggyu Moon, Sung-Ho Her, Won Young Jang, Keon-Woong Moon, Ki-Dong Yoo, Kyusup Lee, Jae Hwan Lee, Jang Hoon Lee, Sang Rok Lee, Seung-Whan Lee, Kyeong Ho Yun, Hyun-Jong Lee, Ik Jun Choi\",\"doi\":\"10.5144/0256-4947.2022.291\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Diabetes mellitus (diabetes) increases the risk of severe coronary artery calcification, which increases the complexity of percutaneous coronary intervention requiring rotational atherectomy (RA) by interfering with lesion preparation, and limiting final stent expansion.</p><p><strong>Objective: </strong>Investigate 30-day and 18-month clinical outcomes in patients with and without diabetes treated with percutaneous coronary intervention requiring RA.</p><p><strong>Design: </strong>Medical record review SETTING: Multicenter registry in South Korea PATIENTS AND METHODS: The ROtational atherectomy in Calcified lesions in Korea (ROCK) registry was a large, retrospective, multicenter study to assess RA treatment of severe coronary artery calcification.</p><p><strong>Main outcome measures: </strong>The primary endpoint was target-vessel failure including cardiac death, target-vessel myocardial infarction, and target-vessel revascularization.</p><p><strong>Sample size: </strong>540 patients followed for a median of 16.1 months.</p><p><strong>Results: </strong>Of the 540 patients, 305 had diabetes (56.5%). The diabetes group had a significantly higher frequency of multivessel disease; comorbidities such as hypertension, dyslipidemia, and chronic kidney disease; and lower ejection fraction of the left ventricle compared to the non-diabetes group (n=235). There were no significant differences in procedure success and complications observed between the two groups. Target vessel failure at 30 days between the diabetes and non-diabetes groups was not statistically significant in a multivariate Cox regression analysis (1.6% vs. 2.6%, adjusted hazard ratio [HR] 0.595, 95% confidence interval [CI] 0.154-2.300, <i>P</i>=.451). During an 18-month follow-up, the risk of target vessel failure was higher (12.5% vs. 8.9%) but the difference was not statistically significant (adjusted HR 1.393, 95% CI 0.782-2.482, <i>P</i>=.260).</p><p><strong>Conclusions: </strong>Patients with diabetes have a risk of complications comparable to patients without diabetes, and 30-day and 18-month clinical outcomes are similar in severe coronary artery calcification requiring RA, despite having more comorbidities.</p><p><strong>Limitations: </strong>Retrospective design. 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引用次数: 1
摘要
背景:糖尿病增加了冠状动脉严重钙化的风险，这增加了经皮冠状动脉介入治疗的复杂性，需要旋转动脉粥样硬化切除术(RA)，干扰病变准备，限制最终支架扩张。目的:探讨需要RA的经皮冠状动脉介入治疗的糖尿病和非糖尿病患者30天和18个月的临床结果。设计:医疗记录回顾设置:韩国患者的多中心登记和方法:韩国钙化病变旋转动脉粥样硬化切除术(ROCK)登记是一项大型、回顾性、多中心研究，旨在评估RA对严重冠状动脉钙化的治疗。主要结局指标:主要终点是靶血管衰竭，包括心源性死亡、靶血管心肌梗死和靶血管重建术。样本量:540例患者随访时间中位数为16.1个月。结果:540例患者中，糖尿病305例(56.5%)。糖尿病组多血管病变发生率显著增高;合并症，如高血压、血脂异常和慢性肾病;左心室射血分数低于非糖尿病组(n=235)。两组手术成功率及并发症无显著差异。多因素Cox回归分析显示，糖尿病组和非糖尿病组30天靶血管衰竭发生率差异无统计学意义(1.6% vs. 2.6%，校正风险比[HR] 0.595, 95%可信区间[CI] 0.154-2.300, P= 0.451)。在18个月的随访中，靶血管衰竭的风险较高(12.5%比8.9%)，但差异无统计学意义(调整后危险度1.393,95% CI 0.782-2.482, P= 0.260)。结论:糖尿病患者的并发症风险与非糖尿病患者相当，尽管有更多的合并症，但在需要RA的严重冠状动脉钙化中，30天和18个月的临床结果相似。局限性:回顾性设计。样本大小不是基于功率计算。利益冲突:无。
Impact of diabetes mellitus on periprocedural and 18-month clinical outcomes in Korean patients requiring rotational atherectomy: results from the ROCK Registry.
Background: Diabetes mellitus (diabetes) increases the risk of severe coronary artery calcification, which increases the complexity of percutaneous coronary intervention requiring rotational atherectomy (RA) by interfering with lesion preparation, and limiting final stent expansion.
Objective: Investigate 30-day and 18-month clinical outcomes in patients with and without diabetes treated with percutaneous coronary intervention requiring RA.
Design: Medical record review SETTING: Multicenter registry in South Korea PATIENTS AND METHODS: The ROtational atherectomy in Calcified lesions in Korea (ROCK) registry was a large, retrospective, multicenter study to assess RA treatment of severe coronary artery calcification.
Main outcome measures: The primary endpoint was target-vessel failure including cardiac death, target-vessel myocardial infarction, and target-vessel revascularization.
Sample size: 540 patients followed for a median of 16.1 months.
Results: Of the 540 patients, 305 had diabetes (56.5%). The diabetes group had a significantly higher frequency of multivessel disease; comorbidities such as hypertension, dyslipidemia, and chronic kidney disease; and lower ejection fraction of the left ventricle compared to the non-diabetes group (n=235). There were no significant differences in procedure success and complications observed between the two groups. Target vessel failure at 30 days between the diabetes and non-diabetes groups was not statistically significant in a multivariate Cox regression analysis (1.6% vs. 2.6%, adjusted hazard ratio [HR] 0.595, 95% confidence interval [CI] 0.154-2.300, P=.451). During an 18-month follow-up, the risk of target vessel failure was higher (12.5% vs. 8.9%) but the difference was not statistically significant (adjusted HR 1.393, 95% CI 0.782-2.482, P=.260).
Conclusions: Patients with diabetes have a risk of complications comparable to patients without diabetes, and 30-day and 18-month clinical outcomes are similar in severe coronary artery calcification requiring RA, despite having more comorbidities.
Limitations: Retrospective design. Sample size not based on power calculation.
期刊介绍：
The Annals of Saudi Medicine (ASM) is published bimonthly by King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. We publish scientific reports of clinical interest in English. All submissions are subject to peer review by the editorial board and by reviewers in appropriate specialties. The journal will consider for publication manuscripts from any part of the world, but particularly reports that would be of interest to readers in the Middle East or other parts of Asia and Africa. Please go to the Author Resource Center for additional information.
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