Rashid, M, Jackson, M, Austin, D, Kwok, CS, Kontopantelis, E, Ludman, P, de Belder, M, Mamas, MA ORCID: 0000-0001-9241-8890 and Zaman, A (2018) The impact of diabetes on the prognostic value of left ventricular function following percutaneous coronary intervention: Insights from the British Cardiovascular Intervention Society. Catheterization and Cardiovascular Interventions, 92 (6). pp. 393-402. ISSN 1522-1946

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Abstract

Objectives To study the relationship between diabetes mellitus (DM) and left ventricular (LV) function on outcomes following percutaneous coronary intervention (PCI). Background Methods DM is a growing public health challenge worldwide and a significant risk factor for cardiovascular disease and heart failure. All PCI procedures performed between 2006 and 2013 with LV function and diabetic status recorded in the BCIS-NICOR database were included. Demographic, procedural, and clinical outcomes data were collected. Multivariable logistic regression was used to provide adjusted estimates of clinical outcome by LV function and DM, including DM sub-type. Results Conclusions Of 260,726 patients, DM was present in 52,160 (20%); moderate LV systolic dysfunction (LVSD) was present in 51,266 (20%), and severe LVSD in 18,148 (7%). Worsening LVSD in diabetic patients was associated with poorer prognosis following PCI; moderate LVSD odds ratio (OR) 2.03 (95% CI 1.72-2.38) and severe LVSD OR 4.17 (95% CI 3.52-4.93). There was a higher crude and adjusted mortality rate for patients with DM across all grades of LVSD. However, the relative effect of DM appeared attenuated in the severe LVSD group compared with moderate or good LV function, particularly evident in patients with insulin requiring DM (good LV OR 2.09 [95% CI 1.66-2.65]; moderate LVSD OR 1.56 [95% CI 1.26-1.93], poor LV OR 1.40 [95% CI 1.13-1.74]). DM was associated with increased 30-day mortality for all grades of LV function. The prognostic impact of DM was strongest in patients with normal LV function and less evident in patients with severe LV systolic dysfunction.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: 'The impact of diabetes on the prognostic value of left ventricular function following percutaneous coronary intervention: Insights from the British Cardiovascular Intervention Society', which has been published in final form at DOI TBC. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Uncontrolled Keywords: coronary heart disease; percutaneous coronary interventions; diabetes mellitus; left ventricular systolic dysfunction; British Cardiovascular Intervention Society; National Institute of Cardiovasular Outcomes
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Depositing User: Symplectic
Date Deposited: 03 Apr 2018 09:08
Last Modified: 06 Dec 2018 13:45
URI: http://eprints.keele.ac.uk/id/eprint/4686

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