Long-term impact of diabetes on mortality in patients undergoing unprotected left main percutaneous coronary intervention (PCI): a propensity score-matched analysis from the BIA-LM registry
Authors' conclusion
No 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.
Study context
- Population
- Patients undergoing unprotected left main coronary artery (LMCA) PCI, December 27, 2007 to February 21, 2022, BIA-LM registry, Poland; median age 71 (63–79) years, 28.2% women
- Participants
- 998 patients214 propensity score-matched (PSM) pairs
- Exposure
- Diabetes vs no diabetes
- Diabetesn = 250
- Outcome
- All-cause mortality
- Follow-up
- Longest available (mean 4.2 years)
Methodological detailssingle-center registry, propensity score-matched, observational
- Single-center registry
- Propensity score-matched
- Observational
Main finding
As reported in the abstract
All-cause mortality, PSM cohort (214 pairs)
No significant difference in all-cause mortality between groups after PSM (adjusted HR)
1.27
95% CI 0.91–1.77P = 0.16
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| All-cause mortality, overall cohort · longest available follow-up (mean 4.2 years)Worse prognosis with diabetes | HR 1.35 (95% CI 1.03–1.76) | P = 0.03 | |
| All-cause mortality by subgroup, PSM cohortDiabetesvs ControlWorse outcomes with diabetes | HR (two-stent angioplasty) 3.70 (95% CI 1.64–8.34) | P = 0.002 | |
| All-cause mortality by subgroup, PSM cohortDiabetesvs ControlWorse outcomes with diabetes | HR (elective PCI) 2.07 (95% CI 1.29–3.31) | P = 0.003 | |
| All-cause mortality by subgroup, PSM cohortDiabetesvs ControlBetter survival with diabetes | HR (presenting with MI) 0.56 (95% CI 0.35–0.90) | P = 0.02 | |
| 0.10.31310Ratio (log scale) |
- All-cause mortality by subgroup, PSM cohort — No significant difference in outcomes in patients with HF (HR)
- 1.29 (95% CI 0.88-1.89, P = 0.19)
- All-cause mortality by subgroup, PSM cohort — No significant difference in outcomes in patients with CKD (HR)
- 1.08 (95% CI 0.69-1.71, P = 0.19)
- All-cause mortality by subgroup, PSM cohort — No significant difference in outcomes with intravascular imaging use (HR)
- 1.38 (95% CI 0.70-2.71, P = 0.35)
- All-cause mortality by subgroup, PSM cohort — No significant difference in outcomes with concomitant multivessel disease (HR)
- 1.14 (95% CI 0.75-1.73, P = 0.53)
Original publication
Long-term impact of diabetes on mortality in patients undergoing unprotected left main PCI: a propensity score-matched analysis from the BIA-LM registry. Cardiovasc Diabetol. Published 21 April 2025. doi:10.
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