Impact of Diabetes duration on Clinical outcome in Patients receiving Rotational Atherectomy from ROCK Registry : a multicenter, retrospective study. 

Background: There are limited data regarding the clinical impact of diabetes duration for patients with heavy calcified coronary lesions. We sought to determine the clinical impact of diabetes duration on clinical outcomes in patients with heavily calcified lesions required rotational atherectomy (RA) during percutaneous coronary intervention (PCI). Methods: : A total of 540 diabetic patients (583 lesions) were enrolled between January 2010 and October 2019. Patients were classified into 3 subgroups: patients with no diabetes mellitus (non-DM), shorter duration of DM (S-DM), and longer duration of DM (L-DM), of which duration was divided at 10 years. The primary outcome was target-vessel failure (TVF), a composite outcome of cardiac death, target-vessel myocardial infarction, or target-vessel revascularization. Results: : During 18 months of follow-up-duration, diabetes duration was significantly associated with the primary outcome. The incidence rate of TVF, primary outcome, was significantly higher in the L-DM group compared with non-DM or S-DM groups (non-DM, 30 [12.0%] vs. S-DM, 9 [13.9%] vs. L-DM, 29 [21.6%]; p=0.039). Among secondary outcomes, any repeat revascularization was frequently observed in the L-DM compared with other groups (non-DM, 19 [7.6%] vs. S-DM, 6 [9.2%] vs. L-DM, 21 [15.7%]; p=0.042). In multivariate analysis, the risk of TVF and any RR was 1.9 times and 2.4 times higher in L-DM than in non-DM, respectively. Conclusions: : This study was firstly demonstrated that the association between a longer DM duration and poor clinical outcomes in patients with severe calcified CAD after PCI. More careful monitoring for recurrence is needed during follow-up in those patients