DIABETES is often thought to complicate heart procedures, but a new single-centre study demonstrates that coronary orbital atherectomy has comparable safety and effectiveness in patients with and without diabetes.
Diabetes and Advanced Heart Procedures
Diabetes is a recognised risk factor for coronary artery disease and is frequently associated with more challenging, calcified coronary lesions. Patients with diabetes typically have more comorbidities, including high cholesterol and hypertension, and are prone to poorer cardiovascular outcomes. Coronary orbital atherectomy, a technique used to treat severely calcified arteries before stent placement, offers an opportunity to address one of the most complex challenges in contemporary cardiology. Yet, until now, it has not been clear whether diabetes affected the safety or efficacy of this procedure.
Study Outcomes
In this real-world analysis from Mount Sinai Medical Center, 609 patients underwent percutaneous coronary intervention with orbital atherectomy. Among them, 43 percent had diabetes, and these patients displayed higher rates of comorbid conditions like dyslipidaemia and hypertension. Despite this, there were no statistically significant differences in either procedural complications or adverse clinical events in hospital or at 1- or 2-year follow-up. Major outcomes—such as cardiac death, heart attack, and stroke—remained similar, regardless of diabetes status. These findings reinforce previous registry data showing that clinical results are comparable between diabetes and non-diabetes groups undergoing advanced plaque modification.
Diabetes in Future Cardiac Interventions
The study provides reassurance to clinicians treating patients with diabetes and severe coronary artery disease that orbital atherectomy is a viable, safe approach. The comparable outcomes suggest patient selection for this technique can be made without hesitation purely on the basis of diabetes diagnosis. However, as diabetes continues to drive the global burden of heart disease, future research with longer-term follow-up is needed to confirm these findings and optimise care pathways.
Reference
Klein B et al. Real‐world outcome of coronary orbital atherectomy in diabetic versus non‐diabetic patients: a single‐center experience. Catheterization and Cardiovascular Interventions. 2025.DOI:10.1002/ccd.70210.
