The long-term value of sirolimus- and paclitaxel-eluting stents over bare metal stents in patients with diabetes mellitus
European Heart Journal , Volume 28 - Issue 1 p. 26- 32
Aims: To investigate the outcome of a real world diabetic patient cohort treated with bare metal stents (BMS), sirolimus-, or paclitaxel-eluting stents (SES and PES, respectively). Due to the different mechanisms of action of both drugs it is currently unknown which device is the best option to treat these high-risk patients. Methods and results: The study compares the 2-year clinical outcome of 708 consecutive diabetic patients (25% insulin treated) treated with either a BMS (n = 252), a SES (n = 206), or a PES (n = 250), as part of the RESEARCH and T-SEARCH registries. Target vessel revascularization was 19.5% in the BMS group, vs. 15.3% in the SES group and 9.7% in the PES group. PES (21.2%), but not SES (28.9%), were superior to BMS (29.7%) in reducing major adverse cardiac events. After propensity analyses, none of the differences remained significant. The incidence of stent thrombosis (ST) was high in both DES groups. Conclusion: There was a trend towards a more favourable outcome associated with the use of PES over BMS. There was no significant difference between SES and PES in each of the clinical endpoints, and neither in the NIDDM patients, which are hypothesized to be better-off with PES.
|Diabetes, Paclitaxel-eluting stent, Restenosis, Sirolimus-eluting stent|
|European Heart Journal|
|Organisation||Department of Cardiology|
Daemen, J, Garcia-Garcia, H.M, Kukreja, N, Imani, F, de Jaegere, P.P.T, Sianos, G, … Serruys, P.W.J.C. (2007). The long-term value of sirolimus- and paclitaxel-eluting stents over bare metal stents in patients with diabetes mellitus. European Heart Journal, 28(1), 26–32. doi:10.1093/eurheartj/ehl412