Effects Of Percutaneous Coronary Intervention On Viable Myocardium And Heart Function Of Diabetic Patients With Chronic Total Occlusion

Objective: We aim to compare the effects of percutaneous coronary intervention (PCI) on coronary chronic total occlusion (CTO) patients with or without diabetes mellitus (DM). Background: CTO is common in coronary heart disease (CHD) patients with DM. There was no study to compare clinical outcomes of PCI between CHD patients with and without DM. Methods: A total of 78 patients were divided into DM group and NDM group according to whether the patient has DM. The results of PCI were analyzed using quantitative coronary analysis (QCA). In addition, all the patients underwent 99mTc-MIBI Single-photon emission computed tomography (SPECT) and ultrasonic cardiogram (UCG) in the 1st week and the 6th month after PCI to evaluate PCI results. During the 6-month follow-up, MACE was recorded and analyzed as well. Results: The 1st and 2nd class of collateral circulation between the 2 groups have significant differences (P<0.05). Left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI) were decreased at the 6th month compared with those at the 1st week. Left ventricular ejection fraction (LVEF) was significantly increased. In both groups, the defect size significantly reduced and percentage of radionuclide scintigraphic count significantly increased between rest and nitroglycerin interventional SPECT. There were no significant differences in defect sizes and percentage of radionuclide scintigraphic count between the two groups. After 6 months, both groups repeated nitroglycerin interventional SPECT, which showed that defect size was significantly reduced and the percentage of radionuclide scintigraphic count was significantly increased compared with those of the 1st week. During the 6-month follow-up, the incidence of MACE between the two groups had no significant difference. Conclusion: PCI has beneficial effects on heart functions and MACE when performed on CTO patients with and without DM.