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 (2008). Two-year clinical outcome after implantation of sirolimus-eluting and paclitaxel-eluting stents in diabetic patients. European Heart Journal, 29(6), pp. 718-25. Oxford: Oxford University Press 10.1093/eurheartj/ehn021

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine

UniBE Contributor:

Billinger, Michael; Wenaweser, Peter Martin; Cook, Stéphane; Togni, Mario; Seiler, Christian; Stettler, Christoph; Eberli, Franz; Wandel, Simon; Jüni, Peter; Meier, Bernhard and Windecker, Stephan

ISSN:

0195-668X

ISBN:

18272504

Publisher:

Oxford University Press

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:56

Last Modified:

27 Apr 2018 09:04

Publisher DOI:

10.1093/eurheartj/ehn021

PubMed ID:

18272504

Web of Science ID:

000254293500009

BORIS DOI:

10.7892/boris.23980

URI:

https://boris.unibe.ch/id/eprint/23980 (FactScience: 45539)

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