Impact of diabetes mellitus type 2 on in-hospital outcome after cardiac catheterizations in a large cohort of octogenarians.

AIM

To assess the impact of diabetes mellitus type 2 (DM) in 1085 octogenarians on in-hospital outcome after cardiac catheterization (CATH) and/or percutaneous coronary intervention (PCI).

METHODS AND RESULTS

We studied 1085 consecutive octogenarians [82.6+/-2.6 years; 401 DM, 684 without DM (non-DM)]. Age, acute myocardial infarctions (DM: 26%, non-DM: 21%) and extent of disease (three-vessel disease, DM: 34%, non-DM: 31%) were similar in both groups. There was a similar percentage of interventions (PCI: DM: 30% vs. non-DM: 29%; bypass surgery: DM: 30% vs. non-DM: 25%) performed in both groups. Thirty-one patients (2.9%) died during hospital stay (DM: 2.2%; non-DM: 3.2%; p=0.46) of whom 16 died (DM: 1.0%; non-DM: 1.9%) during (n=4) or after (n=12) interventions in patients who were already admitted in cardiogenic shock. At the puncture site, 87 complications occurred (DM 6.5% vs. non-DM 6.4%, p=0.87). Stepwise logistic regression analyses identified DM as an independent predictor of adverse events during CATH, but not PCI. Furthermore, DM was not a predictor for vascular complications.

CONCLUSIONS

Catheterization-related complication rates are different in diabetic as compared to nondiabetic patients during CATH, but not PCI. Octogenarians should be granted access to an invasive treatment strategy even in the presence of DM.