Evidence mapPaperPMID 40259359Full record

Observational studyCardiovascular diabetology2025

Long-term impact of diabetes on mortality in patients undergoing unprotected left main PCI: a propensity score-matched analysis from the BIA-LM registry.

Paweł Kralisz, Emil Julian Dąbrowski, Sławomir Dobrzycki, Wiktoria Urszula Kozłowska, Patrycja Oliwia Lipska, Konrad Nowak, Kamil Gugała, Przemysław Prokopczuk, Grzegorz Mężyński, Michał Święczkowski and 1 more

Abstract readObservational Study
In one paragraph

Observational study in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

11 authors.

Paweł Kralisz *Department of Invasive Cardiology, Medical University of Białystok, 1 Kilińskiego St., 15-089, Białystok, Poland.
Emil Julian Dąbrowski *Department of Invasive Cardiology, Medical University of Białystok, 1 Kilińskiego St., 15-089, Białystok, Poland. e.j.dabrowski@gmail.com.ORCID 0000-0001-7598-1913
Sławomir DobrzyckiDepartment of Invasive Cardiology, Medical University of Białystok, 1 Kilińskiego St., 15-089, Białystok, Poland.
Wiktoria Urszula KozłowskaDepartment of Invasive Cardiology, Medical University of Białystok, 1 Kilińskiego St., 15-089, Białystok, Poland.
Patrycja Oliwia LipskaDepartment of Invasive Cardiology, Medical University of Białystok, 1 Kilińskiego St., 15-089, Białystok, Poland.
Konrad NowakDepartment of Invasive Cardiology, Medical University of Białystok, 1 Kilińskiego St., 15-089, Białystok, Poland.
Kamil GugałaDepartment of Invasive Cardiology, Medical University of Białystok, 1 Kilińskiego St., 15-089, Białystok, Poland.
Przemysław ProkopczukDepartment of Invasive Cardiology, Medical University of Białystok, 1 Kilińskiego St., 15-089, Białystok, Poland.
Grzegorz MężyńskiDepartment of Invasive Cardiology, Medical University of Białystok, 1 Kilińskiego St., 15-089, Białystok, Poland.
Michał ŚwięczkowskiDepartment of Invasive Cardiology, Medical University of Białystok, 1 Kilińskiego St., 15-089, Białystok, Poland.
Marcin KożuchDepartment of Invasive Cardiology, Medical University of Białystok, 1 Kilińskiego St., 15-089, Białystok, Poland.

Funding

Uniwersytet Medyczny w Bialymstoku B.SUB.25.504Uniwersytet Medyczny w Bialymstoku B.SUB.25.535
6 · The paper itself

Abstract

backgroundThere is modest data on long-term impact of diabetes on left main coronary artery (LMCA) percutaneous coronary intervention (PCI). This observational study, based on the largest single-center registry of LMCA PCI in Poland, evaluated the impact of diabetes on long-term survival following PCI in a real-world setting.

methodsWe retrospectively analyzed 998 patients who underwent LMCA PCI between December 27, 2007, and February 21, 2022. Diabetes and insulin dependence were defined based on medical history, prior records, and prescribed treatment. The endpoint was all-cause mortality at the longest available follow-up (mean 4.2 years). Survival analysis was conducted in the overall cohort and a one-to-one propensity score-matched (PSM) population. Moderation effects and differences between subgroups were analysed in predefined groups of PSM cohort.

resultsThe median age was 71 (63-79) years; 212 (28.2%) were women, and 250 (33.2%) had diabetes. In the overall cohort, diabetes was associated with a worse prognosis (HR 1.35, 95% CI 1.03-1.76, P = 0.03). PSM resulted in 214 well-balanced pairs (median age 73 years (66-79)), with no significant difference in all-cause mortality between groups (adjusted HR 1.27, 95% CI 0.91-1.77, P = 0.16). After PSM subgroup analysis showed worse outcomes for patients with diabetes undergoing two-stent angioplasty (HR 3.70, 95% CI 1.64-8.34, P = 0.002) and elective PCI (HR 2.07, 95% CI 1.29-3.31, P = 0.003). Conversely, among patients presenting with myocardial infarction (MI), people with diabetes had better survival than the control group (HR 0.56, 95% CI 0.35-0.90, P = 0.02). No significant differences in outcomes were observed in patients with heart failure (HR 1.29, 95% CI 0.88-1.89, P = 0.19), chronic kidney disease (HR 1.08, 95% CI 0.69-1.71, P = 0.19), intravascular imaging use (HR 1.38, 95% CI 0.70-2.71, P = 0.35), or concomitant multivessel disease (HR 1.14, 95% CI 0.75-1.73, P = 0.53).

conclusionsNo significant association was observed between diabetes and overall mortality following LMCA PCI. Sensitivity analyses showed worse survival outcomes in diabetic patients treated with two-stent techniques and undergoing non-emergency PCI. These findings suggest the overall safety of PCI for LMCA in people with diabetes and highlight the need for randomized trials, especially investigating indicated high-risk subgroups.

Indexed as

Coronary Artery DiseaseDiabetes MellitusPercutaneous Coronary InterventionAgedFemaleHumansMaleMiddle AgedPolandPropensity ScoreRegistriesRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeCADCoronary artery diseaseDiabetesLeft mainPCIPropensity score matchingRegistry

Identifiers

PMID40259359
PMCPMC12013000

What Socratic holds

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LicenceCC BY-NC-ND
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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.