Two-year clinical outcome after implantation of sirolimus-eluting and paclitaxel-eluting stents in diabetic patients
Billinger, Michael ; Beutler, Jonas ; Taghetchian, Keywan R. ; Remondino, Andrea ; Wenaweser, Peter ; Cook, Stéphane ; Togni, Mario ; Seiler, Christian ; Stettler, Christoph ; Eberli, Franz R. ; Lüscher, Thomas F. ; Wandel, Simon ; Jüni, Peter ; Meier, Bernhard ; Windecker, Stephan
In: European Heart Journal, 2008, vol. 29, no. 6, p. 718-725
Ajouter à la liste personnelle- Summary
- Aims Percutaneous coronary intervention (PCI) in diabetic patients is associated with an increased risk of restenosis and major adverse cardiac events (MACE). We assessed the impact of diabetes on long-term outcome after PCI with sirolimus-eluting (SES) and paclitaxel-eluting (PES) stents. Methods and results In the SIRTAX trial, 1012 patients were randomized to treatment with SES (n = 503) or PES (n = 509). A stratified analysis of outcomes was performed according to the presence or absence of diabetes. Baseline characteristics were well balanced between SES and PES in patients with (N = 201) and without diabetes (N = 811). Clinical outcome was worse in diabetic compared with non-diabetic patients regarding death (9.0% vs. 4.1%, P = 0.004) and MACE (defined as cardiac death, myocardial infarction, or TLR; 19.9% vs. 12.7%, P = 0.007) at 2 years. Among diabetic patients, SES reduced MACE by 47% (14.8% vs. 25.8%, HR = 0.52, P = 0.05) and TLR by 61% (7.4% vs. 17.2%, HR = 0.39, P = 0.03) compared with PES at 2 years. Conclusion Diabetic patients have worse prognosis than non-diabetic patients undergoing PCI with DES. Among the diabetic patient population of this trial, SES reduce repeat revascularization procedures and MACE more effectively than PES and to a similar degree as in non-diabetic patients