title: Paclitaxel- and sirolimus-eluting stents in older patients with diabetes mellitus: results of a real-life multicenter registry.
abstract: BACKGROUND
  Older patients and diabetes mellitus (DM) are rapidly increasing in Western world populations. The treatment of coronary artery disease in these patients is challenging because they are complex and at high risk. Performance of the two widely used drug-eluting stents (DES), i.e. sirolimus- (SES) and paclitaxel-eluting stent (PES), is understudied in this subset.
  
  
  OBJECTIVE
  We aimed to explore the impact of the first generation DES choice on mid term outcome in a large and unselected population of diabetic patients older than 65 years.
  
  
  RESULTS
  From a multicenter registry of 2,429 diabetic patients treated with sirolimus- (SES) or paclitaxel-eluting stent (PES), 1,417 patients ≥65 years old were analyzed overall and separately for groups aged 65-74 (67%) and ≥75 (33%) years old. SES (55%) were compared to PES (45%) in terms of major adverse cardiac events, including all-cause death, myocardial infarction (MI) and target lesion revascularization (TLR) throughout 1-to-5 year follow-up (median time 24 months). We failed to find at the unadjusted and adjusted analyses statistically significant differences in term of outcome between the two DES, both in the overall cohort and in the two different aged subgroups, also regardless of the insulin treatment.
  
  
  CONCLUSIONS
  In this real-life multicenter registry, PES and SES showed a comparable safety and efficacy profile in diabetic patients older than 65 years throughout 1-to-5 years follow-up.
authors.affiliation: Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua Medical School, Padua, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Buja
authors.forename: Michela
authors.initials: M
authors.lastname: Facchin
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Musumeci
authors.forename: Anna Chiara
authors.initials: AC
authors.lastname: Frigo
authors.forename: Francesco
authors.initials: F
authors.lastname: Saia
authors.forename: Alberto
authors.initials: A
authors.lastname: Menozzi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Meliga
authors.forename: Gennaro
authors.initials: G
authors.lastname: Sardella
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarantini
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D003920:Diabetes Mellitus / Q000401:mortality; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D017239:Paclitaxel / Q000008:administration & dosage*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D057216:Propensity Score; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D017239:Paclitaxel; D020123:Sirolimus