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

Abstract

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.