Simsek, Cihan; Räber, Lorenz; Magro, Michael; Boersma, Eric; Onuma, Yoshinobu; Stefanini, Giulio; Zanchin, Thomas; Kalesan, Bindu; Wenaweser, Peter Martin; Jüni, Peter; van Geuns, Robert; van Domburg, Ron T; Windecker, Stephan; Serruys, Patrick W (2013). Long-term outcome of the unrestricted use of everolimus-eluting stents compared to sirolimus-eluting stents and paclitaxel-eluting stents in diabetic patients: The Bern–Rotterdam diabetes cohort study. International journal of cardiology, 170(1), pp. 36-42. Elsevier 10.1016/j.ijcard.2013.10.006
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BACKGROUND
Newer generation everolimus-eluting stents (EES) improve clinical outcome compared to early generation sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES). We investigated whether the advantage in safety and efficacy also holds among the high-risk population of diabetic patients during long-term follow-up.
METHODS
Between 2002 and 2009, a total of 1963 consecutive diabetic patients treated with the unrestricted use of EES (n=804), SES (n=612) and PES (n=547) were followed throughout three years for the occurrence of cardiac events at two academic institutions. The primary end point was the occurrence of definite stent thrombosis.
RESULTS
The primary outcome occurred in 1.0% of EES, 3.7% of SES and 3.8% of PES treated patients ([EES vs. SES] adjusted HR=0.58, 95% CI 0.39-0.88; [EES vs. PES] adjusted HR=0.29, 95% CI 0.13-0.67). Similarly, patients treated with EES had a lower risk of target-lesion revascularization (TLR) compared to patients treated with SES and PES ([EES vs. SES], 5.6% vs. 11.5%, adjusted HR=0.68, 95% CI: 0.55-0.83; [EES vs. PES], 5.6% vs. 11.3%, adjusted HR=0.51, 95% CI: 0.33-0.77). There were no differences in other safety end points, such as all-cause mortality, cardiac mortality, myocardial infarction (MI) and MACE.
CONCLUSION
In diabetic patients, the unrestricted use of EES appears to be associated with improved outcomes, specifically a significant decrease in the need for TLR and ST compared to early generation SES and PES throughout 3-year follow-up.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology 04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM) 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Kardiologie 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Kardiologie |
UniBE Contributor: |
Räber, Lorenz, Stefanini, Giulio, Kalesan, Bindu, Wenaweser, Peter Martin, Jüni, Peter, Windecker, Stephan |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
0167-5273 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Doris Kopp Heim |
Date Deposited: |
18 Dec 2013 09:26 |
Last Modified: |
05 Dec 2022 14:27 |
Publisher DOI: |
10.1016/j.ijcard.2013.10.006 |
PubMed ID: |
24196314 |
Uncontrolled Keywords: |
ARC Academic Research Consortium Adjusted Hazard Ratio BMS Bare-Metal Stents CI Confidence Interval DES DM Diabetes Mellitus Diabetes mellitus Drug-Eluting Stents ECG EES ElectroCardioGraphy Everolimus-Eluting Stents Everolimus-eluting stent IQR Inter Quartile Range MACE MI Major Adverse Cardiac Events Myocardial Infarction PCI PES Paclitaxel-Eluting Stents Paclitaxel-eluting stent Percutaneous Coronary Intervention Percutaneous coronary intervention RESEARCH Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital SD SES ST Sirolimus-Eluting Stents Sirolimus-eluting stent Standard Deviation Stent Thrombosis T-SEARCH TLR TVR Target-Lesion Revascularization Target-Vessel Revascularization Taxus–Stent Evaluated At Rotterdam Cardiology Hospital X-SEARCH XIENCE-Stent Evaluated At Rotterdam Cardiology Hospital aHR |
BORIS DOI: |
10.7892/boris.39544 |
URI: |
https://boris.unibe.ch/id/eprint/39544 |
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