PMID- 29137044
OWN - NLM
STAT- MEDLINE
DCOM- 20171204
LR  - 20221005
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 45
DP  - 2017 Nov
TI  - Outcomes of percutaneous coronary intervention in patients with coronary chronic 
      total occlusions with versus without type 2 diabetes mellitus: A systematic 
      review and meta-analysis.
PG  - e8499
LID - 10.1097/MD.0000000000008499 [doi]
LID - e8499
AB  - BACKGROUND: Nowadays, due to advanced techniques and well-trained 
      interventionists in catheter labs, new scientific research has shown percutaneous 
      coronary intervention (PCI) to be a safe treatment procedure in patients with 
      chronic total occlusion (CTO). However, no study has systematically compared PCI 
      outcomes in CTO patients with versus without type 2 diabetes mellitus (T2DM). 
      Therefore, through this meta-analysis we aimed to systematically solve this 
      issue. METHODS: Between September 2016 and June 2017, the Cochrane Database of 
      Randomized Trials, EMBASE, and MEDLINE databases were carefully searched for 
      publications comparing PCI outcomes in CTO patients with versus without T2DM. 
      Long-term (>/=1 year) adverse clinical outcomes were considered the endpoints. 
      Discontinuous data were analyzed by RevMan 5.3 whereby odds ratios (OR) and 95% 
      confidence intervals (CIs) were the statistical parameters. RESULTS: This 
      analysis consisted of 1 randomized trial and 6 observational studies with a total 
      number of 4571 patients with CTO (1915 patients with T2DM and 2656 patients 
      without T2DM). Patients' enrollment was between the years 1998 and 2015.During 
      this long-term follow-up (>/=1 year), mortality was significantly higher in CTO 
      patients with T2DM (OR: 1.56, 95% CI: 1.05-2.31; P = .03, I = 0%). Major adverse 
      cardiac events (MACEs) and repeated revascularization were also significantly 
      higher in patients with T2DM (OR: 1.30, 95% CI: 1.06-1.58; P = .01, I = 10%) and 
      (OR: 1.30, 95% CI: 1.06-1.59; P = .01, I = 36%) respectively. However, myocardial 
      infarction was not significantly different (OR: 1.01, 95% CI: 0.61-1.67; P = .96, 
      I = 26%). CONCLUSION: During this longer follow-up period post-PCI, mortality, 
      MACEs and repeated revascularization in CTO patients with T2DM were significantly 
      higher compared with similar patients without T2DM. Nevertheless, whether this 
      hypothesis is relevant or not should be confirmed in larger trials.
FAU - Wang, Qiang
AU  - Wang Q
AD  - Institute of Cardiovascular Diseases, Yichang Central People's Hospital, Yichang, 
      Hubei Province Institute of Cardiovascular Diseases, The Second Affiliated 
      Hospital of Guangxi Medical University, Nanning, Guangxi, P. R. China.
FAU - Liu, Hao
AU  - Liu H
FAU - Ding, Jiawang
AU  - Ding J
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Chronic Disease
MH  - Coronary Occlusion/*epidemiology/*surgery
MH  - Diabetes Mellitus, Type 2/*epidemiology
MH  - Humans
MH  - Myocardial Infarction/etiology
MH  - Percutaneous Coronary Intervention/*adverse effects/*mortality
PMC - PMC5690737
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2017/11/16 06:00
MHDA- 2017/12/05 06:00
PMCR- 2017/11/10
CRDT- 2017/11/16 06:00
PHST- 2017/11/16 06:00 [entrez]
PHST- 2017/11/16 06:00 [pubmed]
PHST- 2017/12/05 06:00 [medline]
PHST- 2017/11/10 00:00 [pmc-release]
AID - 00005792-201711100-00040 [pii]
AID - MD-D-17-05757 [pii]
AID - 10.1097/MD.0000000000008499 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Nov;96(45):e8499. doi: 10.1097/MD.0000000000008499.