CORONARY ARTERY DISEASE Original Studies Impact of Diabetes Mellitus Status on Coronary Pathoanatomy and Interventional Treatment: Insights From the Euro Heart Survey PCI registry Timm Bauer, 1 * MD, Helge Mo ¨ llmann, 1 MD, Franz Weidinger, 2 MD, Uwe Zeymer, 3 MD, Ricardo Seabra-Gomes, 4 MD, Franz Eberli, 5 MD, Patrick Serruys, 6 MD, Alec Vahanian, 7 MD, Sigmund Silber, 8 MD, William Wijns, 9 MD, Matthias Hochadel, 3 PhD, Holger M. Nef, 1 MD, Christian W. Hamm, 1 MD, Jean Marco, 10 MD, and Anselm K. Gitt, 3 MD Objectives: The present analysis was performed to evaluate the impact of diabetes mellitus (DM) status on the severity of coronary artery disease (CAD) and current approaches in interventional treatment. Background: Little is known about the effect of DM treated with diet, oral agents, or insulin on lesion characteristics and anatomical pattern of CAD and their interventional treatment. Methods and results: Patients (n 5 46,779) of the contemporary Euro Heart Survey PCI registry with known DM status were included in this analysis. Nondiabetics (n 5 35,280, 75.4%) were compared with diabetics treated with diet (n 5 1,533, 3.3%), oral agents (n 5 7,222, 15.4%), and insulin (n 5 2,744, 5.8%). Diabetic patients were older, suffered more frequently from comor- bidities and presented more often with cardiogenic shock. The number of severely ste- nosed (70%) segments incrementally increased from nondiabetics to insulin-requiring diabetics. The location of lesions did not differ between patients with and without DM. The ratio stenosed/treated segments progressively rose among the four patient cohorts. The severity of DM negatively correlated with the extent of complete revascu- larization. After adjustment for confounding variables no significant differences in hos- pital mortality could be observed between patients without DM and diabetics treated with diet, but a significantly higher rate of death was seen in diabetic patients with oral medication and insulin therapy. Conclusions: Although CAD was more severe in patients with DM the percentage of treated segments with 70% stenosis was lower. Adjusted hospital mortality was increased among diabetics treated with oral medica- tion or insulin, but not among those treated with diet. V C 2011 Wiley Periodicals, Inc. Key words: PCI; percutaneous coronary intervention; ANGO; angiography; coronary; CATH; diagnostic cardiac catheterization 1 Kerckhoff Heart Center, Bad Nauheim, Germany 2 Krankenhaus Rudolfstiftung, Vienna, Austria 3 Herzzentrum Ludwigshafen, Institut fu ¨ r Herzinfarktforschung Ludwigshafen an der Universita ¨ t Heidelberg, Germany 4 Instituto do Corac ¸a ˘ o, Lisbon, Portugal 5 Stadtspital Triemli, Zurich, Switzerland 6 Thorax Center, Erasmus MC, Rotterdam, Netherlands 7 Bichat Hospital, Paris, France 8 Kardiologische Gemeinschaftspraxis und Praxisklinik, Mu- nich, Germany 9 Cardiovascular Center, Aalst, Belgium 10 Centre Cardiothoracique de Monaco, Monaco The members of the ESC Board Committee for the Euro Heart Sur- vey Programme 2006–2008 are as follows: Anselm K. Gitt (Chair- person) (Germany), Hector Bueno (Spain), Nicolas Danchin (France), Kevin Fox (UK), Peter Kearney (Ireland), Aldo Maggioni (Italy), Keith McGregor (France), Gregorsz Opolski (Poland), Ricardo Seabra-Gomes (Portugal), and Franz Weidinger (Austria). *Correspondence to: Timm Bauer, MD, Kerckhoff Heart Center, Department of Cardiology, Benekestr, 2-8, 61231 Bad Nauheim, Ger- many. E-mail: Bauer-Timm@gmx.de Received 8 August 2010; Revision accepted 11 December 2010 DOI 10.1002/ccd.22939 Published online 21 July 2011 in Wiley Online Library (wileyonlinelibrary.com) V C 2011 Wiley Periodicals, Inc. Catheterization and Cardiovascular Interventions 78:702–709 (2011)