Percutaneous coronary intervention using various types of stents in acute coronary syndrome without st segment elevation in patients with type 2 diabetes mellitus: long-term results

Background. The combination of acute coronary syndrome with diabetes mellitus is characterized by an extremely high risk of complicated course of the disease and worsening prognosis.

Results. The study included 306 patients with acute coronary syndrome without ST-segment elevation on ECG, who underwent PCI for emergency indications. The patients were divided into 2 groups depending on the presence/absence of concomitant type 2 diabetes mellitus. It was established that the results of observation showed that the presence of diabetes mellitus in patients with acute coronary syndrome significantly affects the pathophysiological features of pathology, on the one hand, and the clinical course, on the other. Clinical signs of myocardial ischemia were significant in the group with diabetes mellitus relative to the group without diabetes mellitus (p < 0.05). The primary use of the PCI stent showed that when using BMS, signs of myocardial ischemia were significantly more common after using BMS compared with CCBMS (p < 0.05). The results of the CAG revealed that stent restenosis occurred more often with BMS compared with CCBMS (p < 0.05) and more often in the presence of diabetes mellitus compared with its absence (p < 0.05). 12 months after the primary event, the levels of endocan, FRT and CRP were higher in patients with diabetes mellitus compared with patients without diabetes mellitus (p < 0.05) and in patients who had BMS compared with patients who had CCBMS both in the group of patients suffering from diabetes mellitus and in the group without diabetes mellitus (p < 0.05). In restenosis, the indicators of endocan, FRT and CRP were higher compared with patients without restenosis, both in the presence of diabetes mellitus and in its absence (p < 0.05). The data of the correlation test revealed that in the absence of diabetes mellitus, the value of the endocan upon admission was positively correlated with the risk of restenosis in both BMS and CCBMS (r = 0.65). In patients with diabetes mellitus, the risks of intra-stent restenosis and the occurrence of hemodynamically significant stenoses of other localization correlated with the levels of glycated hemoglobin upon admission for the primary event (r = 0.63). In the group of patients without diabetes, there was a direct correlation between the risk of developing restenosis and low-density lipoprotein cholesterol levels (r = 0.67).

Conclusion. In patients with acute coronary syndrome without ST segment elevation on an ECG, the presence of type 2 diabetes mellitus progresses the course of the disease and worsens patient outcomes. The use of CCBMS in acute coronary syndrome significantly reduces the frequency of coronary artery restenosis in stents, especially in the presence of diabetes.

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