Impact of diabetes and acute coronary syndrome on survival in patients treated with drug-eluting stents.

BACKGROUND Diabetics who undergo percutaneous coronary intervention (PCI) are at increased risk for death, myocardial infarction, repeat revascularization, and stent thrombosis. METHODS Our retrospective study includes 887 consecutive patients who underwent PCI with drug-eluting stents (DES) at UCLA Medical Center. The cohort was divided into four groups: group 1, no diabetes and no acute coronary syndrome (ACS); group 2, no diabetes and ACS; group 3, diabetes and no ACS; group 4, diabetes and ACS. RESULTS Survival at 1 year was the lowest in diabetics who presented with ACS (90% in diabetics with ACS, 95% in diabetics without ACS, 95% in non-diabetics with ACS, and 96% in the non-diabetics without ACS, P = 0.03). At 1 year, age, diabetes, chronic renal insufficiency, ejection fraction, and myocardial infarction were identified as independent predictors for mortality. CONCLUSION In the DES era, diabetics who undergo PCI for ACS continue to have an excess risk of death and major adverse cardiac events at 1 year.