Table 1. Baseline demographics and angiographic characteristics of entire population with successful and Failed revascularization
|
Entire population (n = 739)
|
|
Success
(n = 619)
|
Failed
(n = 120)
|
P value
|
Age (yrs)
|
67 + 13
|
69 + 13
|
0.14
|
Gender (male)
|
568 (92)
|
107 (89)
|
0.38
|
Hypertension
|
467 (75)
|
96 (80)
|
0.35
|
DM
|
265 (43)
|
48 (40)
|
0.61
|
Hyperlipidemia
|
267 (43)
|
53 (44)
|
0.84
|
Prior stroke
|
51 (8)
|
11 (9)
|
0.72
|
PAD
|
34 (6)
|
11 (9)
|
0.14
|
Smoking
|
253 (41)
|
47 (39)
|
0.76
|
Prior MI
|
135 (22)
|
24 (20)
|
0.72
|
Prior PCI
|
317 (51)
|
66 (55)
|
0.49
|
Prior CABG
|
61 (10)
|
15 (13)
|
0.41
|
LVEF (%)
|
49 + 12
|
48 + 13
|
0.61
|
eGFR, MDRDc (ml/min)
|
84 + 33
|
76 + 34
|
0.01
|
LDL (mg/dl)
|
102 + 35
|
97 + 32
|
0.19
|
HbA1C (%)
|
8.0 + 3.8
|
7.6 + 1.7
|
0.51
|
Location of CTO
|
|
|
|
LAD
|
271 (44)
|
46 (38)
|
0.31
|
LCx
|
159 (26)
|
37 (31)
|
0.26
|
RCA
|
293 (47)
|
63 (53)
|
0.32
|
J CTO score
|
2.45 + 1.00
|
2.55 + 0.96
|
0.32
|
MVD
|
501 (81)
|
106 (88)
|
0.07
|
Lesion length (mm)
|
38 + 18
|
32 + 11
|
0.01
|
Lesion width (mm)
|
3.2 + 3.6
|
3.0 + 0.5
|
0.73
|
Primary retrograde
|
48 (8)
|
8 (7)
|
0.34
|
Values are given as mean and standard deviation or numbers and percentages.
DM, diabetes mellitus; PCI, percuatneous coronary intervention; PAD, peripheral arterial disease; MI, myocardial infarct; PCI, percutaneous coronary intervention; CABG, coronary artery bypass graft surgery; LVEF, left ventricular ejection fraction; eGFR, estimated glomerular filtration rate; MDRDc, modification of diet in renal disease Chinese; LDL, low density lipoprotein; CTO, chronic total occlusion; CAD, coronary artery disease; LAD, left anterior descending; LCx: left cirumflex; RCA, right coronary artery; MVD, multivessel significant coronar y artery disease
Table 2. Baseline demographics and angiographic characteristics of diabetes and non diabetes population with successful and Failed revascularization
|
Diabetes mellitus (n = 313)
|
Non Diabetes (n = 426)
|
|
Success
(n = 265)
|
Failed
(n = 48)
|
P value
|
Success
(n = 354)
|
Failed
(n = 72)
|
P value
|
Age (yrs)
|
70 + 12
|
70 + 13
|
0.71
|
66 + 14
|
68 + 13
|
0.10
|
Gender (Male)
|
229 (86)
|
42 (88)
|
1
|
339 (96)
|
65 (90)
|
0.08
|
Hypertension
|
226 (85)
|
42 (88)
|
0.83
|
241 (68)
|
54 (75)
|
0.27
|
Hyperlipidemia
|
121 (46)
|
26 (54)
|
0.35
|
146 (41)
|
27 (38)
|
0.60
|
Prior stroke
|
25 (9)
|
8 (17)
|
0.13
|
26 (7)
|
3 (4)
|
0.45
|
PAD
|
18 (7)
|
7 (15)
|
0.08
|
16 (5)
|
4 (6)
|
0.76
|
Smoking
|
92 (35)
|
17 (35)
|
1.00
|
161 (46)
|
30 (42)
|
0.60
|
Prior MI
|
77 (29)
|
15 (31)
|
0.73
|
58 (16)
|
9 (13)
|
0.48
|
Prior PCI
|
151 (57)
|
24 (50)
|
0.43
|
166 (47)
|
42 (58)
|
0.09
|
Prior CABG
|
28 (11)
|
8 (17)
|
0.22
|
33 (9)
|
7 (10)
|
0.83
|
LVEF (%)
|
47 + 12
|
47 + 12
|
0.92
|
50 + 12
|
48 + 14
|
0.36
|
eGFR, MDRDc (ml/min)
|
78 + 36
|
67 + 32
|
0.06
|
89 + 29
|
82 + 34
|
0.06
|
LDL (mg/dl)
|
98 + 33
|
92 + 30
|
0.39
|
106 + 36
|
100 + 34
|
0.29
|
HbA1C
|
7.9 + 1.7
|
7.7 + 1.7
|
0.57
|
-
|
-
|
-
|
Non invasive test
|
|
|
0.616
|
|
|
0.068
|
Treadmill
|
50 (19)
|
6 (13)
|
|
80 (23)
|
7 (10)
|
|
Thallium scan
|
202 (77)
|
40 (83)
|
|
247 (70)
|
61 (85)
|
|
Others
|
12 (5)
|
2 (4)
|
|
27 (7)
|
4 (5)
|
|
OAD
|
191 (72)
|
32 (67)
|
0.62
|
-
|
-
|
-
|
Metformin
|
39 (15)
|
6 (13)
|
|
|
|
|
Sulphonylurea
|
15 (6)
|
5 (11)
|
|
|
|
|
DPP4 inhibitor
|
5 (2)
|
5 (11)
|
|
|
|
|
Meglitinide
|
1 (1)
|
1 (2)
|
|
|
|
|
Combined regimen
|
81 (31)
|
12 (25)
|
|
|
|
|
Combined insulin and OAD
|
31 (12)
|
4 (8)
|
|
|
|
|
Insulin (%)
|
55 (21)
|
13 (27)
|
0.62
|
-
|
-
|
-
|
Location of CTO
|
|
|
|
|
|
|
LAD
|
107 (40)
|
16 (33)
|
0.42
|
164 (46)
|
30 (42)
|
0.52
|
LCx
|
68 (26)
|
16 (33),
|
0.29
|
91 (26)
|
21 (29)
|
0.56
|
RCA
|
138 (52)
|
30 (63)
|
0.21
|
155 (44)
|
33 (46)
|
0.80
|
J CTO score
|
2.54 + 1.00
|
2.66 + 1.00
|
0.38
|
2.31 + 0.99
|
2.40 + 0.89
|
0.537
|
Syntax score
|
18 + 6
|
20 + 7
|
0.03
|
19 + 6
|
20 + 7
|
0.24
|
MVD
|
224 (85)
|
46 (96)
|
0.04
|
277 (78)
|
60 (83)
|
0.43
|
Lesion length (mm)
|
38 + 18
|
31 + 9
|
0.12
|
38 + 18
|
32 + 12
|
0.05
|
Lesion width (mm)
|
3.0 + 1.6
|
3.0 + 0.6
|
0.96
|
3.3 + 4.5
|
3.0 + 0.3
|
0.72
|
Primary retrograde
|
22 (9)
|
2 (5)
|
0.85
|
26 (8)
|
6 (8)
|
1.00
|
Values are given as mean and standard deviation or numbers and percentages.
PCI, percuatneous coronary intervention; PAD, peripheral arterial disease; MI, myocardial infarct; PCI, percutaneous coronary intervention; CABG, coronary artery bypass graft surgery; LVEF, left ventricular ejection fraction; eGFR, estimated glomerular filtration rate; MDRDc, modification of diet in renal disease Chinese; LDL, low density lipoprotein; HbA1C, glycated hemoglobin; OAD, oral anti-diabetic drug; CTO, chronic total occlusion; CAD, coronary artery disease; LAD, left anterior descending; LCx, left circumflex; RCA, right coronary artery; MVD, multivessel significant coronary artery disease.
Table 3. Baseline demographics and angiographic characteristics of diabetes population with successful and Failed PCI after propensity score matching
|
Success (n = 188)
|
Failed (n = 47)
|
P value
|
Age, yrs
|
71 + 12
|
71 + 13
|
0.96
|
Gender (Male)
|
158 (84)
|
41 (87)
|
0.66
|
Hypertension
|
160 (85)
|
42 (89)
|
0.64
|
Hyperlipidemia
|
80 (43)
|
24 (51)
|
0.33
|
Prior stroke
|
19 (10)
|
6 (13)
|
0.60
|
PAD
|
16 (9)
|
7 (15)
|
0.27
|
Smoking
|
61 (32)
|
17 (36)
|
0.73
|
Prior MI
|
56 (30)
|
16 (34)
|
0.60
|
Prior CAD
|
111 (59)
|
24 (51)
|
0.33
|
Prior CABG
|
18 (10)
|
9 (19)
|
0.08
|
LVEF, %
|
47 + 12
|
47 + 12
|
0.92
|
eGFR, MDRDc (ml/min)
|
69 + 29
|
68 + 30
|
0.76
|
LDL (mg/dl)
|
98 + 34
|
93 + 29
|
0.51
|
HbA1C, %
|
7.7 + 1.6
|
8 + 1.5
|
0.49
|
Location of CTO
|
|
|
|
LAD
|
14 (26)
|
5 (39)
|
0.50
|
LCx
|
28 (44)
|
1 (11)
|
0.08
|
RCA
|
23 (37)
|
10 (56)
|
0.18
|
Multivessel CTO
|
29 (15)
|
15 (32)
|
0.05
|
J CTO score
|
2.4 + 0.5
|
2.5 + 0.6
|
0.60
|
Syntax score
|
18 + 5
|
19 + 5
|
0.78
|
MVD
|
163 (87)
|
45 (96)
|
0.05
|
Lesion length (mm)
|
37 + 18
|
31 + 8
|
0.12
|
Lesion width (mm)
|
3.0 + 2.0
|
3.0 + 0.6
|
0.92
|
Retrograde approach
|
14 (8)
|
2 (5)
|
0.89
|
Values are given as mean and standard deviation or numbers and percentages.
PCI = percuatneous coronary intervention; PAD = peripheral arterial disease; CABG = coronary artery bypass graft surgery; LVEF = left ventricular ejection fraction; eGFR = estimated glomerular filtration rate; LDL = low density lipoprotein; CTO = chronic total occlusion; CAD = coronary artery disease, LAD, left anterior descending; LCx, left circumflex; RCA, right coronary artery; MVD, multivessel significant coronary artery disease.
Table 4. Various clinical outcomes up to 3 years by Kaplan-Meier curved analysis
|
Incidence of event at 3 years [n (%)]
|
|
Procedure
|
HR (95% CI)
|
P value
|
Entire population
|
Successful PCI (n = 619)
|
Failed PCI (n = 120)
|
|
|
All cause mortality
|
59 (10)
|
18 (15)
|
0.593 (0.349 – 1.008)
|
0.054
|
CV mortality
|
22 (4)
|
9 (8)
|
0.472 (0.217 – 1.024)
|
0.057
|
Nonfatal MI
|
18 (3)
|
4 (3)
|
0.867 (0.294 – 2.563)
|
0.797
|
MACE
|
80 (13)
|
20 (17)
|
0.734 (0.449 – 1.200)
|
0.218
|
Diabetes patients
|
Successful PCI (n = 265)
|
Failed PCI (n = 48)
|
|
|
All cause mortality
|
25 (9)
|
13 (27)
|
0.307 (0.156 – 0.604)
|
0.001
|
CV mortality
|
9 (3)
|
6 (13)
|
0.266 (0.095 – 0.748)
|
0.012
|
Nonfatal MI
|
11 (4)
|
3 (6)
|
0.652 (0.182 – 2.338)
|
0.512
|
MACE
|
39 (15)
|
14 (29)
|
0.454 (0.246 – 0.837)
|
0.011
|
Non diabetes patients
|
Successful PCI (n = 354)
|
Failed PCI (n = 72)
|
|
|
All cause mortality
|
34 (10)
|
4 (7)
|
1.334 (0.521 – 3.417)
|
0.548
|
CV mortality
|
13 (4)
|
3 (4)
|
0.885 (0.252 – 3.107)
|
0.849
|
Nonfatal MI
|
7 (2)
|
1 (1)
|
1.423 (0.175 – 11.565)
|
0.741
|
MACE
|
41 (12)
|
6 (8)
|
1.351 (0.573 – 3.188)
|
0.491
|
Diabetes patients after matching
|
Successful PCI (n = 188)
|
Failed PCI (n = 47)
|
|
|
All cause mortality
|
21 (11)
|
12 (26)
|
0.386 (0.188 – 0.789)
|
0.009
|
CV mortality
|
7 (4)
|
6 (13)
|
0.268 (0.090 – 0.798)
|
0.018
|
Nonfatal MI
|
8 (4)
|
3 (6)
|
0.584 (0.154 – 2.210)
|
0.429
|
MACE
|
28 (15)
|
13 (28)
|
1.511 (0.338 – 6.753)
|
0.589
|
CV, cardiovascular; MI, myocardial infarct; MACCE, major adverse cardiovascular and cerebrovascular events (defined as the composite of all-cause mortality, cardiovascular mortality, non fatal myocardial infarct and stroke)
Table 5. Periprocedural complications
|
Diabetes patients
|
Non-diabetes patients
|
|
Successful PCI (n = 265)
|
Failed PCI (n = 48)
|
P value
|
Successful PCI (n = 354)
|
Failed PCI (n = 72)
|
P value
|
In hospital mortality
|
1 (1)
|
1 (2)
|
0.28
|
3 (1)
|
2 (3)
|
0.07
|
Pericardial effusion required pericardiocentesis
|
2 (1)
|
0 (0)
|
0.72
|
2 (1)
|
3 (4)
|
0.04
|
Cardiogenic shock required mechanical support
|
2 (1)
|
0(0)
|
0.72
|
3 (1)
|
1 (1)
|
0.53
|
CIN required renal replacement therapy
|
2 (1)
|
0 (0)
|
0.72
|
1 (1)
|
0 (0)
|
0.83
|
Vascular complications required surgery
|
3 (1)
|
1 (2)
|
0.49
|
3 (1)
|
0 (0)
|
0.57
|
Periprocedural MI
|
5 (2)
|
3 (6)
|
0.11
|
6 (2)
|
0 (0)
|
0.33
|
MI, myocardial infarct; CIN, contrast induced nephropathy
Table 6. Univariate and multivariate analysis of successful revascularization on three-years all cause mortality before matching
|
Univariate analysis
|
Multivariate analysis
|
|
HR (95% CI)
|
P value
|
HR (95% CI)
|
P value
|
Successful revascularization
|
0.307 (0.156 – 0.604)
|
0.001
|
0.289 (0.125 – 0.667)
|
0.004
|
Age
|
1.044 (1.015 – 1.075)
|
0.003
|
1.034 (0.997 – 1.073)
|
0.071
|
Gender
|
3.607 (0.873 – 14.902)
|
0.076
|
-
|
-
|
eGFR
|
0.990 (0.981 – 1.000)
|
0.053
|
0.996 (0.985 – 1.007)
|
0.465
|
LDL
|
0.991 (0.979 – 1.003)
|
0.150
|
-
|
-
|
HbA1C
|
0.830 (0.637 – 1.081)
|
0.166
|
-
|
-
|
Prior stroke
|
2.409 (1.158 – 5.012)
|
0.019
|
1.961 (0.725 – 5.308)
|
0.185
|
Prior PAD
|
3.109 (1.494 – 6.469)
|
0.002
|
3.322 (1.276 – 8.646)
|
0.014
|
Prior MI
|
1.147 (0.576 – 2.282)
|
0.697
|
|
|
Hypertension
|
1.302 (0.513 – 3.302)
|
0.579
|
-
|
-
|
Multivessel disease
|
1.205 (0.746 – 1.946)
|
0.445
|
|
|
LAD
|
1.575 (0.872 – 2.846)
|
0.132
|
-
|
-
|
Syntax score
|
1.054 (0.995 – 1.117)
|
0.074
|
|
|
LVEF
|
0.960 (0.933 – 0.988)
|
0.005
|
0.955 (0.927 – 0.984)
|
0.003
|
MDRDc: Modification of diet in renal disease Chinese; LDL, low density lipoprotein; HbA1C, glycated hemoglobulin; PAD, peripheral arterial disease; LAD, left anterior descending; LVEF, left ventricular ejection fraction.
Table 7. Univariate and multivariate analysis of successful revascularization on three-years all cause mortality after matching
|
Univariate analysis
|
Multivariate analysis
|
|
HR (95% CI)
|
P value
|
HR (95% CI)
|
P value
|
Successful revascularization
|
0.386 (0.188 – 0.789)
|
0.009
|
0.348 (0.142 – 0.851)
|
0.021
|
Age
|
1.045 (1.010 – 1.081)
|
0.012
|
1.041 (0.997 – 1.087)
|
0.069
|
Gender
|
2.789 (0.667 – 11.673)
|
0.160
|
-
|
-
|
eGFR
|
0.987 (0.975 – 0.999)
|
0.040
|
0.995 (0.979 – 1.011)
|
0.516
|
LDL
|
0.993 (0.980 – 1.007)
|
0.346
|
-
|
-
|
HbA1C
|
0.671 (0.386 – 1.169)
|
0.159
|
-
|
-
|
Prior stroke
|
2.598 (1.123 – 6.009)
|
0.026
|
2.207 (0.736 – 6.621)
|
0.158
|
Prior PAD
|
1.825 (0.703 – 4.740)
|
0.217
|
-
|
-
|
Prior MI
|
1.176 (0.567 – 2.440)
|
0.662
|
|
|
Hypertension
|
1.603 (0.488 – 5.261)
|
0.437
|
-
|
-
|
Multi vessel disease
|
0.680 (0.226 – 2.048)
|
0.493
|
|
|
LAD
|
0.194 (0.024 – 1.577)
|
0.125
|
-
|
-
|
Syntax score
|
1.024 (0.888 – 1.180)
|
0.745
|
|
|
LVEF
|
0.965 (0.933 – 0.999)
|
0.045
|
0.961 (0.928 – 0.996)
|
0.027
|
MDRDc: Modification of diet in renal disease Chinese; LDL, low density lipoprotein; HbA1C, glycated hemoglobulin; PAD, peripheral arterial disease; LAD, left anterior descending; LVEF, left ventricular ejection fraction.