The influence of XXXX on the practice and outcomes of percutaneous coronary intervention in the community: a report from the HCA database.

@entity1 @entity75 @entity6 @entity299
BACKGROUND: Diabetics remain a high-risk group for those undergoing percutaneous coronary intervention (PCI) using balloon angioplasty and/or intracoronary stents for myocardial revascularization. The objective of this study is to compare clinical characteristics, demographics, procedure indications, lesion characteristics, and acute and long-term outcomes between @entity6 @entity1 and non- @entity6 @entity1 in a community based PCI registry. METHODS AND RESULTS: Information on @entity1 demographics, coronary risk factors, lesion characteristics, procedures, and outcomes were derived from an HCA, Inc. database on all @entity1 undergoing a PCI procedure in one of four community cardiac catheterization laboratories (CCL). A total of 3,139 @entity1 who underwent PCI procedures from July 1, 1999 through September 30, 2000 were enrolled in this study. Approximately one-third of these @entity1 completed a follow-up survey one year after their initial encounter. Analysis was limited to those @entity1 undergoing PCI of native vessels with stents or conventional balloon angioplasty; @entity1 with @entity75 in bypass grafts or those treated with atherectomy were excluded. Approximately 23.5% of the @entity1 enrolled in the study were @entity6 . This study found no significant difference in any acute outcome between @entity6 and non- @entity6 @entity1 in the hospital episode associated with the index PCI procedure. However, data from the 1-year follow-up survey indicates @entity6 @entity1 tended to have more @entity75 revascularization (TLR) (13.6% versus 8.9%; p = 0.07) and more target vessel revascularization (TVR) (17.6% versus 12.7%; p = 0.058) than non- @entity6 @entity1 . In addition, adjusted odds ratios indicate that @entity6 @entity1 were 1.6 times more likely to have a second PCI procedure in another vessel (p = 0.013), 2.4 times more likely to undergo bypass surgery (p = 0.003), 1.9 times more likely to undergo an additional revascularization procedure (p < 0.001) and 1.8 times more likely to experience any major adverse @entity299 (p < 0.001) than non- @entity6 @entity1 during the follow-up period. CONCLUSIONS: This study indicates that selected @entity6 @entity1 can be treated for myocardial revascularization using PCI procedures with acceptable acute outcomes. However, @entity6 @entity1 undergoing PCIs have significantly more disease progression and are more likely to experience the need for recurrent revascularization.
