Diabetes mellitus and 10-year clinical outcomes after percutaneous coronary intervention with drug-eluting stents: insights from the DECADE cooperation
Pooled result · All-cause deathResult — go to the resultAdjusted hazard ratio 1.68 95% CI 1.59–1.78Authors' conclusion
DM was associated with distinct temporal patterns of adverse outcomes after PCI with DES, with an early associations with MI and definite ST, as well as an increased risk of death and repeat revascularisation in the longer term. These findings further emphasize the need for intensified secondary prevention and provide a long-term benchmark against which novel management strategies should be evaluated in patients with DM undergoing PCI.
Study context
- Population
- Patients treated with drug-eluting stents (drug-eluting stent (DES)) during percutaneous coronary intervention (PCI) in five randomized controlled trials with available 10-year follow-up, grouped by diabetes mellitus (DM) diagnosis at baselinepatients pooled
- Participants
- 9,699 patients
- Comparison
- Patients with DM compared with patients without DM
- DMn = 2,298
- Outcome
- All-cause death
- Follow-up
- Up to 10 years
Methodological details10-year follow-up, multivariable analyses, subgroup analyses, landmark analyses
- 10-year follow-up
- Multivariable analyses
- Subgroup analyses
- Landmark analyses
Pooled result
As reported in the abstract
Adjusted hazard ratio
1.68
95% CI 1.59–1.78
DMvs NO DM
HRadj 1.68 (95% CI 1.59–1.78)
Further pooled results
| Outcome | HRadj (CI) | |
|---|---|---|
| Cardiovascular death · up to 10 years | 1.74 (1.63–1.87) | |
| Definite ST | 1.55 (1.18–2.04) | |
| TLR | 1.35 (1.21–1.51) | |
| TVR | 1.28 (1.14–1.43) | |
| nTVR | 1.23 (1.09–1.40) | |
| 0.512Adjusted hazard ratio (log scale) |
Landmark analyses
- The excess myocardial infarction (MI) risk was predominantly observed within the first month
- The excess definite stent thrombosis (ST) risk was detected between 30 days and 1 year
Subgroups by age, sex, clinical presentation, and DES-generation
- Association between DM at baseline and clinical outcomes varied across subgroups
- All Pinteraction <0.001
Insulin-treated patients
- Insulin-treated patients represent the higher risk phenotype
Original publication
Diabetes mellitus and 10-year clinical outcomes after percutaneous coronary intervention with drug-eluting stents: insights from the DECADE cooperation. Cardiovasc Diabetol. Published 11 November 2026. doi:10.
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