title: Clinical outcomes in diabetic and non-diabetic patients with drug-eluting stents: results from the first phase of the prospective multicenter German DES.DE registry.
abstract: BACKGROUND
  Patients with diabetes mellitus (DM) undergoing coronary revascularization are at increased risk for adverse outcomes. Without sufficiently powered data from diabetic subgroup analyses and in absence of randomized controlled trials in diabetic patients with primary clinical outcomes controversy is ongoing over safety and efficacy of drug-eluting stents (DES) in diabetic patients.
  
  
  RESULTS
  Between October 2005 and October 2006, 1,659 diabetic and 3,559 non-diabetic patients treated with DES (Paclitaxel or Sirolimus-eluting stents) were enrolled at 98 Drug-Eluting-Stent.DEutschland (DES.DE) sites. Major adverse cardiac and cerebrovascular events (MACCE), defined as the composite of death, myocardial infarction, and stroke, as well as target vessel revascularization (TVR) were defined as primary endpoints. The baseline clinical and descriptive morphology of coronary artery disease revealed more severe findings in diabetic patients. At 1-year follow-up, diabetic patients treated with DES had significantly higher rates for overall death (5.6 vs. 3.4%; p < 0.01), myocardial infarction (4.8 vs. 3.4%; p = 0.05), stroke (1.7 vs. 0.9%; p < 0.05), MACCE (10.9 vs. 7.1%; p < 0.001), and overall stent thrombosis (4.9 vs. 3.3%; p < 0.01) with slightly elevated rates for TVR (12.0 vs. 10.4%; p = 0.17); data which remained after risk-adjustment.
  
  
  CONCLUSIONS
  Data collected in DES.DE revealed that despite the use of DES the risk of myocardial infarction, death, and thrombotic events remains higher in diabetic patients.
authors.affiliation: Divisions of Cardiology, Pulmonology, Department of Internal Medicine I, Intensive Care Unit, University Hospital Rostock, Rostock School of Medicine, Ernst-Heydemann-Str. 6, 18057, Rostock, Germany.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Akin
authors.forename: Alexander
authors.initials: A
authors.lastname: Bufe
authors.forename: Steffen
authors.initials: S
authors.lastname: Schneider
authors.forename: Holger
authors.initials: H
authors.lastname: Reinecke
authors.forename: Lars
authors.initials: L
authors.lastname: Eckardt
authors.forename: Gert
authors.initials: G
authors.lastname: Richardt
authors.forename: Detlev
authors.initials: D
authors.lastname: Burska
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Nienaber
mesh_terms: D000368:Aged; D023903:Coronary Restenosis / Q000209:etiology*; D003920:Diabetes Mellitus; D003925:Diabetic Angiopathies; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D016896:Treatment Outcome