LONG-TERM OUTCOMES OF PERCUTANEOUS CORONARY INTERVENTIONS (ICP) IN PATIENTS WITH CORONARY ARTERY DISEASE AND DIABETES: A SCOPING REVIEW

Resumen

Introduction: Percutaneous coronary interventions (PCI), stent implantation and balloon angioplasty, are critical therapeutic strategies for managing coronary artery disease (CAD), particularly in patients with diabetes. This scoping review aims to synthesize key findings from the literature on the long-term efficacy and prognosis of drug-eluting stents in diabetic patients, highlighting risks and benefits. Methods: This scoping review followed PRISMA-ScR guidelines, employing a comprehensive search strategy across PubMed (MEDLINE), Embase, and Web of Science. Studies focusing on drug-eluting stents in diabetic patients with coronary artery disease were included. Results: A total of 393 records were identified and, after removing duplicates, 288 records were screened. Following the eligibility assessment, 26 studies were included in the review. The studies indicate that drug eluting-stents reduce restenosis and major adverse cardiac events in diabetic patients, though complications such as stent thrombosis and the need for revascularization persist. Long-term outcomes vary significantly between different generations of stents, although the differences betweenvarious drug-eluting stents were not statistically significant. Diabetic patients, particularly those with high bleeding and ischemic risks, require rigorous follow-up due to elevated complication rates. Conclusion: Diabetic patients with high bleeding and ischemic risks require close monitoring and individualized antiplatelet therapy adjustments. Maintaining dual antiplatelet therapy (DAPT) for at least one year is recommended, potentially longer for high-risk patients. Optimizing glycemic control and managing hypertension and dyslipidemia can reduce long-term cardiovascular events post-stent placement.