title: Paclitaxel-eluting versus sirolimus-eluting stents in diabetes mellitus: a report from the National Heart, Lung, and Blood Institute Dynamic Registry.
abstract: BACKGROUND
  Diabetes is a powerful predictor of adverse events in patients undergoing percutaneous coronary intervention. Drug-eluting stents reduce restenosis rates compared with bare metal stents; however, controversy remains regarding which drug-eluting stents provides greater benefit in patients with diabetes. Accordingly, we compared the safety and efficacy of sirolimus-eluting stents (SES) with paclitaxel-eluting stents (PES) among diabetic patients in a contemporary registry.
  
  
  RESULTS
  Using the National Heart, Lung, and Blood Institute Dynamic Registry, we evaluated 2-year outcomes of diabetic patients undergoing percutaneous coronary interventions with SES (n=677) and PES (n=328). Clinical and demographic characteristics, including age, body mass index, insulin use, left ventricular function, and aspirin/clopidogrel use postprocedure, did not differ significantly between the groups except that PES-treated patients had a greater frequency of hypertension and hyperlipidemia. At the 2-year follow-up, no significant differences were observed between PES and SES with regard to safety or efficacy end points. PES- and SES-treated patients had similar rates of death (10.7% versus 8.2%, P=0.20), death and myocardial infarction (14.9% versus 13.6%, P=0.55), repeat revascularization (14.8% versus 17.8%, P=0.36), and stent thrombosis (1.3% versus 1.3%, P=0.95). After adjustment, no significant differences between the 2 stent types in any outcome were observed.
  
  
  CONCLUSIONS
  PES and SES are equally efficacious and have similar safety profiles in diabetic patients undergoing percutaneous coronary interventions in clinical practice.
authors.affiliation: University of Pittsburgh Medical Center, PA, USA.
authors.forename: William M
authors.initials: WM
authors.lastname: Wolf
authors.forename: Helen A
authors.initials: HA
authors.lastname: Vlachos
authors.forename: Oscar C
authors.initials: OC
authors.lastname: Marroquin
authors.forename: Joon S
authors.initials: JS
authors.lastname: Lee
authors.forename: Conrad
authors.initials: C
authors.lastname: Smith
authors.forename: William D
authors.initials: WD
authors.lastname: Anderson
authors.forename: John T
authors.initials: JT
authors.lastname: Schindler
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Holper
authors.forename: J Dawn
authors.initials: JD
authors.lastname: Abbott
authors.forename: David O
authors.initials: DO
authors.lastname: Williams
authors.forename: Warren K
authors.initials: WK
authors.lastname: Laskey
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
authors.forename: Sheryl F
authors.initials: SF
authors.lastname: Kelsey
authors.forename: Suresh R
authors.initials: SR
authors.lastname: Mulukutla
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003925:Diabetic Angiopathies / Q000503:physiopathology / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D054555:National Heart, Lung, and Blood Institute (U.S.); D017239:Paclitaxel / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage* / Q000009:adverse effects; D014481:United States
chemical_list: D017239:Paclitaxel; D020123:Sirolimus