title: Safety and efficacy of drug-eluting vs. bare metal stents in patients with diabetes mellitus: long-term follow-up in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR).
abstract: OBJECTIVE
  Patients with diabetes mellitus have more extensive coronary artery disease, more disease progression, and restenosis. The use of drug-eluting stents (DES) in these patients is widespread, despite uncertain long-term safety and efficacy.
  
  
  RESULTS
  All consecutive patients with diabetes mellitus in Sweden who underwent percutaneous coronary intervention were entered into the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) during 2003-06 with complete follow-up for 1-4 years (median 2.5). Patients who received at least one DES (n = 4754) were compared with those who received only bare metal stents (BMS) (n = 4956) at the index procedure. Combined outcome of death or myocardial infarction (MI) showed no difference for DES vs. BMS, relative risk (RR), 0.91 [95% confidence interval (CI), 0.77-1.06]. Myocardial infarction was significantly less common with DES in patients who received only one stent RR, 0.80 (95% CI, 0.66-0.96). The restenosis rate was 50% lower in DES-treated patients RR, 0.50 (95% CI, 0.35-0.70) and was associated with a higher adjusted RR of MI, RR, 5.03 (95% CI, 4.25-5.97). DES was associated with reduced restenosis rates in all subgroups of diabetic patients with the greatest benefit in stent diameters <3 mm or stent length >20 mm. The number of lesions treated with DES to prevent one restenosis ranged from 11 to 47 in various subgroups.
  
  
  CONCLUSIONS
  This real-life registry study shows that restenosis was halved by DES in diabetic patients with stable or unstable coronary disease, with similar risk of death or MI up to 4 years compared with BMS.
authors.affiliation: Department of Cardiology, University Hospital, 581 85 Linköping, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Stenestrand
authors.forename: Stefan K
authors.initials: SK
authors.lastname: James
authors.forename: Johan
authors.initials: J
authors.lastname: Lindbäck
authors.forename: Ole
authors.initials: O
authors.lastname: Fröbert
authors.forename: Jörg
authors.initials: J
authors.lastname: Carlsson
authors.forename: Fredrik
authors.initials: F
authors.lastname: Scherstén
authors.forename: Tage
authors.initials: T
authors.lastname: Nilsson
authors.forename: Bo
authors.initials: B
authors.lastname: Lagerqvist
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods / Q000401:mortality; D023903:Coronary Restenosis / Q000401:mortality / Q000517:prevention & control*; D003925:Diabetic Angiopathies / Q000401:mortality / Q000517:prevention & control*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000517:prevention & control; D012042:Registries; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D013548:Sweden / Q000453:epidemiology