title: Long-term clinical benefit of drug-eluting stents over bare-metal stents in diabetic patients with de novo left main coronary artery disease: results from a real-world multicenter registry.
abstract: BACKGROUND
  Few data are available on diabetic patients undergoing percutaneous coronary intervention (PCI) in the context of unprotected left main coronary artery (ULMCA) disease. The main goal of this study was to present the long-term relative benefits of using drug-eluting stent (DES) instead of bare-metal stent (BMS) for diabetic patients submitted to percutaneous ULMCA treatment in a large real world multicenter registry.
  
  
  METHODS
  The GISE-SICI registry is a retrospective, observational multicenter registry promoted by the Italian Society of Invasive Cardiology in which 19 high-volume participating centers enrolled 1,453 consecutive patients who underwent PCI on ULMCA between January 2002 and December 2006. From the registry, a total of 398 consecutive patients with diabetes mellitus who underwent DES (n = 321) or BMS (n = 77) implantation were analyzed, with extensive multivariable adjustments.
  
  
  RESULTS
  At 3-years, use of DES in diabetic patients resulted in no significant differences with respect to death (HR 0.56, 95% CIs 0.24-1.28), myocardial infarction (HR 0.82, 95% CIs 0.21-3.26), and the composite end-point of death or myocardial infarction (HR 0.56, 95% CIs 0.27-1.20). Conversely, DES were associated with significant reduction of target lesion revascularization (TLR, HR 0.33; 95% CIs 0.14-0.80, P = 0.001) rates.
  
  
  CONCLUSIONS
  Patients presenting with ULMCA disease in the context of diabetes mellitus who are treated with stent-supported PCI have a significant reduction in the rate of TLR with no increased risk of death or myocardial infarction.
authors.affiliation: Dipartimento di Cardiologia, Ospedale Ferrarotto, Università di Catania, Italy. dcapodanno@gmail.com
authors.forename: Davide
authors.initials: D
authors.lastname: Capodanno
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Di Salvo
authors.forename: Tullio
authors.initials: T
authors.lastname: Palmerini
authors.forename: Imad
authors.initials: I
authors.lastname: Sheiban
authors.forename: Massimo
authors.initials: M
authors.lastname: Margheri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vecchi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sangiorgi
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Piovaccari
authors.forename: Antonio
authors.initials: A
authors.lastname: Bartorelli
authors.forename: Carlo
authors.initials: C
authors.lastname: Briguori
authors.forename: Diego
authors.initials: D
authors.lastname: Ardissino
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Pede
authors.forename: Angelo
authors.initials: A
authors.lastname: Ramondo
authors.forename: Luigi
authors.initials: L
authors.lastname: Inglese
authors.forename: Anna Sonia
authors.initials: AS
authors.lastname: Petronio
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bolognese
authors.forename: Alberto
authors.initials: A
authors.lastname: Benassi
authors.forename: Cataldo
authors.initials: C
authors.lastname: Palmieri
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Filippone
authors.forename: Stefano
authors.initials: S
authors.lastname: De Servi
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000628:therapy*; D003920:Diabetes Mellitus; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome