Diabetes Mellitus Duration and Major Adverse Cardiovascular Events Following Percutaneous Coronary Intervention: A Prospective Cohort Study.

OBJECTIVE: This study is aimed at evaluating the impact of Type 2 diabetes mellitus (T2DM) duration on major adverse cardiovascular events (MACEs) after percutaneous coronary intervention (PCI). METHODS: A single-center prospective cohort study was conducted in which 465 T2DM patients undergoing PCI and completing the 1-year follow-up were enrolled. Patients were divided into three groups based on duration of DM: < 5 years, 5-10 years, and > 10 years. The primary endpoint was MACE, a composite of nonfatal myocardial infarction (MI), stroke, coronary artery bypass grafting (CABG), repeat PCI, and mortality. RESULTS: The incidence of MACE increased progressively with longer diabetes duration: 3.7% (< 5 years), 8.1% (5-10 years), and 13.9% (> 10 years), with particularly higher rates of stroke (0.6%-3.0%) and repeat PCI (1.8%-6.0%) among T2DM patients after PCI. The Kaplan-Meier analysis demonstrated a clear stepwise rise in cumulative MACE incidence over 12 months, with the highest event rates observed in patients with diabetes for more than 10 years (log-rank p < 0.004). Consistently, Cox proportional hazards models showed significantly elevated risk compared with the < 5-year group, with adjusted hazard ratios of 3.16 (95% CI: 1.06-9.47, p = 0.039) for 5-10 years and 4.37 (95% CI: 1.59-12.01, p = 0.004) for > 10 years. CONCLUSION: Patients with longer duration (> 10 years) of T2DM had the highest incidence and hazard of adverse cardiovascular events compared to shorter duration (< 5 years and 5-10 years). These results suggest that targeted preventive strategies and closer post-PCI monitoring are essential for patients with prolonged diabetes duration.