New data presented at the ESC 2025 Congress highlight the persistent impact of diabetes on long-term outcomes after coronary stenting, showing that its adverse influence is independent of the presence of peripheral arterial disease (PAD).
Researchers from the Thorax Centre in Medisch Spectrum Twente, the Netherlands, pooled patient-level data from four randomized trials including 9,204 all-comer PCI patients treated with new-generation drug-eluting stents. Patients were stratified by PAD status and diabetes diagnosis.
Key findings at three-year follow-up include:
- Among patients with PAD, those with diabetes had a higher MACE rate (24.6% vs. 16.4%; HR 1.56; p=0.01).
- In patients without PAD, diabetes was also linked to increased MACE (16.7% vs. 9.5%; HR 1.83; p<0.01).
- The absolute increase in MACE due to diabetes was +8.2% in PAD patients and +7.2% in non-PAD patients.
Regardless of PAD status, patients with diabetes were older and more likely to have hypertension and higher BMI, contributing to a riskier clinical profile.
The study emphasizes the need for enhanced secondary prevention strategies, aggressive risk factor control, and careful long-term monitoring in PCI patients with diabetes.
