Objective: Whether the effect of diabetes on patients with unprotected left main coronary artery(LMCA) disease differs according to different strategy of revascularization in the era of the second-generation drug-eluting stents(DES) was unknown. Methods: 823 consecutive patients having unprotected LMCA disease, who received the second-generation DES(n=331)(DM,n=99;non-DM,n=232) implantation or underwent CABG(n=492)(DM,n=127;non-DM,n=365)were prospectively enrolled. We compared the effects of diabetes on clinical outcomes according to different strategy of revascularization.Results: Among 823 eligible patients enrolled, 226 had diabetes. During a median follow-up of 25.3 months, no significant differences were observed in occurrences of death, cardiac death, repeat revascularization, stroke and MACCE in the DES population. However, the risks of the composite of death/MI/stroke(21.5% DM vs. 7.2% no-DM,P =0.001) and MI(15.4 % DM vs. 1.6% no-DM,P=0.000) were significantly higher in the diabetic patients compared with those without diabetes. In the CABG population, similar rates of all clinical endpoints were observed between the diabetic and nondiabetic group.Conclusions: Diabetes was associated with worse outcome in patients underwent the second-genaration DES implantation for the treatment of unprotected LMCA disease. However, its negative prognostic impact was not found among patients undergoing CABG.
Journal of Cardiovascular and Pulmonary Diseases