Evidence map›Paper›PMID 37338598›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2023

Intracoronary physiology-guided percutaneous coronary intervention in patients with diabetes.

Roberto Scarsini, Matteo Tebaldi, Francesca Rubino, Sara Sgreva, Giovanni Vescovo, Marco Barbierato, Andrea Vicerè, Domenico Galante, Concetta Mammone, Mattia Lunardi and 5 more

Open access · hybridAbstract readMulticenter Study
In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Outcomes of Fractional Flow Reserve-guided Deferred Coronary Revascularization.Heart views : the official journal of the Gulf Heart Association
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 1 country.

Roberto ScarsiniDivision of Cardiology, Department of Medicine, Verona University Hospital, Piazzale A. Stefani 1, 37126, Verona, Italy. roberto.scarsini@aovr.veneto.it.ORCID http://orcid.org/0000-0002-5916-8882
Matteo TebaldiAzienda Ospedali Riuniti Marche Nord, Emodinamica e Cardiologia Interventistica, Pesaro, Italy.
Francesca RubinoDivision of Cardiology, Department of Medicine, Verona University Hospital, Piazzale A. Stefani 1, 37126, Verona, Italy.
Sara SgrevaDivision of Cardiology, Department of Medicine, Verona University Hospital, Piazzale A. Stefani 1, 37126, Verona, Italy.
Giovanni VescovoOspedale dell'Angelo, Mestre, Italy.
Marco BarbieratoOspedale dell'Angelo, Mestre, Italy.
Andrea VicerèIstituto di Cardiologia Università Cattolica del Sacro Cuore, Rome, Italy.
Domenico GalanteDipartimento di Scienze Cardiovascolari Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Concetta MammoneDivision of Cardiology, Department of Medicine, Verona University Hospital, Piazzale A. Stefani 1, 37126, Verona, Italy.
Mattia LunardiDivision of Cardiology, Department of Medicine, Verona University Hospital, Piazzale A. Stefani 1, 37126, Verona, Italy.
Domenico TavellaDivision of Cardiology, Department of Medicine, Verona University Hospital, Piazzale A. Stefani 1, 37126, Verona, Italy.
Gabriele PesariniDivision of Cardiology, Department of Medicine, Verona University Hospital, Piazzale A. Stefani 1, 37126, Verona, Italy.
Gianluca CampoCardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Cona (Ferrara), Italy.
Antonio Maria LeoneDipartimento di Scienze Cardiovascolari Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Flavio Luciano RibichiniDivision of Cardiology, Department of Medicine, Verona University Hospital, Piazzale A. Stefani 1, 37126, Verona, Italy. flavio.ribichini@univr.it.
University of Verona · ITAgostino Gemelli University Polyclinic · ITOspedale dell' Angelo · ITOspedali Riuniti Marche Nord · ITUniversità Cattolica del Sacro Cuore · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe risk of vessel-oriented cardiac adverse events (VOCE) in patients with diabetes mellitus (DM) undergoing intracoronary physiology-guided coronary revascularization is poorly defined. The purpose of this work is to evaluate the risk of VOCE in patients with and without DM in whom percutaneous coronary intervention (PCI) was performed or deferred based on pressure-wire functional assessment.

methodsThis is a retrospective analysis of a multicenter registry of patients evaluated with fractional flow reserve (FFR) and/or non-hyperaemic pressure ratio (NHPR). Primary endpoint was a composite of VOCE including cardiac death, vessel-related myocardial infarction (MI), and ischemia-driven target vessel revascularization (TVR).

resultsA large cohort of 2828 patients with 3353 coronary lesions was analysed to assess the risk of VOCE at long-term follow-up (23 [14-36] months). Non-insulin-dependent-DM (NIDDM) was not associated with the primary endpoint in the overall cohort (adjusted Hazard Ratio [aHR] 1.18, 95% CI 0.87-1.59, P = 0.276) or in patients with coronary lesions treated with PCI (aHR = 1.30, 95% CI 0.78-2.16, P = 0.314). Conversely, insulin-dependent diabetes mellitus (IDDM) demonstrated an increased risk of VOCE in the overall cohort (aHR 1.76, 95% CI 1.07-2.91, P = 0.027), but not in coronary lesions undergoing PCI (aHR 1.26, 95% CI 0.50-3.16, P = 0.621). Importantly, in coronary lesions deferred after functional assessment IDDM (aHR 2.77, 95% CI 1.11-6.93, P = 0.029) but not NIDDM (aHR = 0.94, 95% CI 0.61-1.44, P = 0.776) was significantly associated with the risk of VOCE. IDDM caused a significant effect modification of FFR-based risk stratification (P for interaction < 0.001).

conclusionOverall, DM was not associated with an increased risk of VOCE in patients undergoing physiology-guided coronary revascularization. However, IDDM represents a phenotype at high risk of VOCE.

Indexed as

Coronary Artery DiseaseDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2Fractional Flow Reserve, MyocardialMyocardial InfarctionPercutaneous Coronary InterventionCoronary AngiographyHumansRetrospective StudiesTreatment OutcomeCoronary artery diseaseDiabetes mellitusFractional flow reserveInstantaneous wave-free ratioInsulin

Identifiers

PMID37338598
PMCPMC10449663
OpenAlexW4381309525

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.