Publication:

Comparison of percutaneous coronary intervention outcomes in diabetic patients with non-ST-elevation myocardial infarction having multivessel disease

Background Diabetic patients with non-ST-elevation myocardial infarction (NSTEMI) and multivessel coronary artery disease (MVD) present unique challenges in revascularization strategy selection. This study compares the clinical outcomes of multivessel (MVR) versus single-vessel revascularization (SVR) using percutaneous coronary intervention (PCI) in such patients.

Methods A prospective observational study was conducted at a tertiary center in Bangladesh including 110 diabetic NSTEMI patients with angiographically confirmed MVD. Patients underwent either MVR (n=58) or SVR (n=52). Outcomes assessed over a 6-month follow-up included major adverse cardiovascular and cerebrovascular events (MACCE), left ventricular ejection fraction (LVEF), functional capacity (METS), and survival.

Results Baseline characteristics were comparable between groups. The MVR group had significantly more stents (2.36±0.49 vs. 1.17±0.38; p<0.01) and longer stent length (58.76±10.22 mm vs. 33.46±10.93 mm; p<0.01). MACCE was significantly lower in the MVR group (6.89% vs. 30.77%; p=0.001), with reduced myocardial infarction and revascularization rates. Both groups showed significant improvement in LVEF and METS post-PCI, with no significant intergroup difference. Kaplan–Meier analysis revealed superior event-free survival in the MVR group.

Conclusions Multivessel PCI offers superior clinical outcomes and event-free survival in diabetic NSTEMI patients with MVD, without increasing periprocedural risks. Individualized risk-benefit assessment remains essential.