title: Comparison of stent thrombosis, myocardial infarction, and mortality following drug-eluting versus bare-metal stent coronary intervention in patients with diabetes mellitus.
abstract: The aim of this study was to examine outcomes subsequent to implantation of drug-eluting stents (DESs) and bare-metal stents (BMSs) in patients with diabetes. From January 2002 to June 2005, data from all percutaneous coronary interventions performed in Western Denmark were prospectively recorded. A total of 1,423 consecutive diabetic patients treated with stent implantation (2,094 lesions) were followed up for 15 months. Of these, 871 patients (1,180 lesions) were treated with a BMS, and 552 patients (914 lesions) were treated with a DES. Dual antiplatelet therapy was recommended for 12 months in both treatment groups. Data for death and myocardial infarction (MI) were ascertained from national health care databases. Use of DESs was not associated with increased risk of definite stent thrombosis (adjusted relative risk [RR] 0.76, 95% confidence interval [CI] 0.10 to 3.26) or MI (adjusted RR 0.90, 95% CI 0.53 to 1.52). In the DES group compared with the BMS group, adjusted RRs of target-lesion revascularization (adjusted RR 0.48, 95% CI 0.33 to 0.71), total mortality (adjusted RR 0.66, 95% CI 0.44 to 0.99), and cardiac mortality (adjusted RR 0.53, 95% CI 0.31 to 0.90) decreased by 52%, 34%, and 47%, respectively. In conclusion, use of DESs reduced target-lesion revascularization in diabetic patients receiving routine clinical care. This result was obtained without increased risk of death, stent thrombosis, or MI.
authors.affiliation: Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, Aarhus, Denmark. michael.maeng@ki.au.dk
authors.forename: Michael
authors.initials: M
authors.lastname: Maeng
authors.forename: Lisette O
authors.initials: LO
authors.lastname: Jensen
authors.forename: Anne
authors.initials: A
authors.lastname: Kaltoft
authors.forename: Hans H T
authors.initials: HH
authors.lastname: Hansen
authors.forename: Morten
authors.initials: M
authors.lastname: Bøttcher
authors.forename: Jens F
authors.initials: JF
authors.lastname: Lassen
authors.forename: Per
authors.initials: P
authors.lastname: Thayssen
authors.forename: Lars R
authors.initials: LR
authors.lastname: Krusell
authors.forename: Klaus
authors.initials: K
authors.lastname: Rasmussen
authors.forename: Lars
authors.initials: L
authors.lastname: Pedersen
authors.forename: Henrik T
authors.initials: HT
authors.lastname: Sørensen
authors.forename: Søren P
authors.initials: SP
authors.lastname: Johnsen
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
mesh_terms: D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D003718:Denmark / Q000453:epidemiology; D048909:Diabetes Complications / Q000401:mortality*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D013927:Thrombosis / Q000209:etiology* / Q000401:mortality*; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin