title: Two-year clinical outcome after implantation of sirolimus-eluting and paclitaxel-eluting stents in diabetic patients.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, University Hospital Bern, 3010 Bern, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Billinger
authors.forename: Jonas
authors.initials: J
authors.lastname: Beutler
authors.forename: Keywan R
authors.initials: KR
authors.lastname: Taghetchian
authors.forename: Andrea
authors.initials: A
authors.lastname: Remondino
authors.forename: Peter
authors.initials: P
authors.lastname: Wenaweser
authors.forename: Stéphane
authors.initials: S
authors.lastname: Cook
authors.forename: Mario
authors.initials: M
authors.lastname: Togni
authors.forename: Christian
authors.initials: C
authors.lastname: Seiler
authors.forename: Christoph
authors.initials: C
authors.lastname: Stettler
authors.forename: Franz R
authors.initials: FR
authors.lastname: Eberli
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Simon
authors.initials: S
authors.lastname: Wandel
authors.forename: Peter
authors.initials: P
authors.lastname: Jüni
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meier
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D023903:Coronary Restenosis / Q000517:prevention & control*; D003925:Diabetic Angiopathies / Q000517:prevention & control*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D009204:Myocardial Revascularization / Q000379:methods; D017239:Paclitaxel / Q000008:administration & dosage*; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage*
chemical_list: D050257:Tubulin Modulators; D017239:Paclitaxel; D020123:Sirolimus