Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Multivessel Disease and Diabetes.

There is a scarcity of data on clinical outcomes after intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with multivessel disease and diabetes. OPTIVUS-Complex PCI study multivessel cohort was a prospective multicenter single-arm trial enrolling 1021 patients who underwent multivessel PCI including left anterior descending coronary artery using IVUS aiming to meet the prespecified OPTIVUS criteria for optimal stent expansion. We compared the clinical outcomes between those patients with and without diabetes. The primary endpoint was a composite of death, myocardial infarction, stroke, or any coronary revascularization. There were 560 patients (54.8%) with diabetes, and 461 patients (45.2%) without diabetes. Mean age was not different between the 2 groups (70.9±9.7 years versus 71.7±10.4 years, P=0.17). Patients with diabetes more often had chronic kidney disease and complex coronary artery disease as indicated by the greater total number of stents and longer total stent length. The rate of meeting OPTIVUS criteria was not different between the 2 groups (61.2% vs. 60.7%, P=0.83). The cumulative 1-year incidence of the primary endpoint was not different between the 2 groups (10.8% versus 9.8%, log-rank P=0.65). After adjusting confounders, the risk of diabetes relative to non-diabetes remained insignificant for the primary endpoint (HR, 0.97; 95%CI, 0.65-1.44; P=0.88). In conclusion, in patients who underwent multivessel IVUS-guided PCI, and were managed with contemporary clinical practice, patients with diabetes had similar 1-year outcomes compared with patients without diabetes.

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Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interests The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Takeshi Kimura reports financial support was provided by Boston Scientific Corp. Takeshi Morimoto reports a relationship with Astrazeneca that includes: speaking and lecture fees. Takeshi Morimoto reports a relationship with Bristol Myers Squibb Co that includes: consulting or advisory and speaking and lecture fees. Takeshi Kimura reports a relationship with Daiichi Sankyo Inc that includes: speaking and lecture fees. Takeshi Morimoto reports a relationship with Daiichi Sankyo Inc that includes: speaking and lecture fees. Takeshi Morimoto reports a relationship with Japan Lifeline that includes: speaking and lecture fees. Takeshi Morimoto reports a relationship with Kowa that includes: speaking and lecture fees. Takeshi Morimoto reports a relationship with Pfizer that includes: consulting or advisory and speaking and lecture fees. Takeshi Morimoto reports a relationship with Tsumura that includes: speaking and lecture fees. Takeshi Morimoto reports a relationship with Novartis that includes: consulting or advisory. Takeshi Morimoto reports a relationship with Teijin that includes: consulting or advisory. Hitoshi Matsuo reports a relationship with Abbott that includes: speaking and lecture fees. Hitoshi Matsuo reports a relationship with Philips that includes: speaking and lecture fees. Hitoshi Matsuo reports a relationship with Zeon Medical that includes: speaking and lecture fees. Hitoshi Matsuo reports a relationship with Kaneka that includes: speaking and lecture fees. Hitoshi Matsuo reports a relationship with Boston Scientific Japan that includes: speaking and lecture fees. Hitoshi Matsuo reports a relationship with Amgen that includes: speaking and lecture fees. Takeshi Kimura reports a relationship with Abbott that includes: consulting or advisory, funding grants, and speaking and lecture fees. Takeshi Kimura reports a relationship with Sanofi that includes: consulting or advisory and speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.