title: A randomized study to compare bioactive titanium stents and everolimus-eluting stents in diabetic patients (TITANIC XV): 1-year results.
abstract: OBJECTIVE
  Up to 25% of patients who undergo a percutaneous coronary intervention show some limitation in the use of drug-eluting stents. The aim of this study was to evaluate if titanium-nitride-oxide-coated stents could be a good alternative to everolimus-eluting stents in diabetic patients.
  
  
  METHODS
  A total of 173 diabetic patients with lesions at moderate risk of restenosis (exclusion criteria: diameter < 2.5 mm or length > 28 mm in vessels < 3mm, chronic occlusion) were randomized to a titanium group (83 patients) or an everolimus group (90 patients).
  
  
  RESULTS
  Baseline characteristics were well balanced; 28.3% of patients were insulin dependent. At 1 year, the incidence of major adverse cardiac events (death, nonfatal myocardial infarction, stroke, or repeat target vessel revascularization) was significantly higher in the titanium group than in the everolimus group (total, 14.5% vs 4.4%; P = .02; noninsulin-dependent subgroup, 9.7% vs 3.2%; P = .14; insulin-dependent subgroup, 28.6% vs 7.1%; P = .04). The incidence of death, nonfatal myocardial infarction, stroke, or any revascularization was 16.9% in the titanium group and 7.8% in the everolimus group (P = .06). Target lesion and vessel revascularizations occurred in 8.4% compared with 3.3% (P = .15) and in 13.3% compared with 3.3% (P = .01) in the titanium and everolimus groups, respectively. Angiographic follow-up at 9 months showed significantly less late lumen loss in the everolimus group (in-segment, 0.52 [standard deviation, 0.58) mm vs -0.05 [0.32] mm; in-stent, 0.76 [0.54] mm vs 0.13 [0.31] mm; P < .0001).
  
  
  CONCLUSIONS
  The everolimus-eluting stent is superior to the titanium stent for clinical and angiographic end points in diabetic patients with lesions at moderate risk of restenosis.
authors: Servicio de Cardiología, Hospital Universitario Infanta Cristina, Badajoz, Spain. Electronic address: lopez-minguez@hotmail.com.
authors: José R
authors: JR
authors: López-Mínguez
authors: Servicio de Cardiología, Hospital Universitario Infanta Cristina, Badajoz, Spain.
authors: Juan M
authors: JM
authors: Nogales-Asensio
authors: Servicio de Cardiología, Hospital Universitario Infanta Cristina, Badajoz, Spain.
authors: Luis J
authors: LJ
authors: Doncel-Vecino
authors: Servicio de Cardiología, Hospital Universitario Infanta Cristina, Badajoz, Spain.
authors: Antonio
authors: A
authors: Merchán-Herrera
authors: Servicio de Cardiología, Hospital Universitario General, Valencia, Spain.
authors: Francisco
authors: F
authors: Pomar-Domingo
authors: Servicio de Cardiología, Hospital Puerto Real, Cádiz, Spain.
authors: Pedro
authors: P
authors: Martínez-Romero
authors: Servicio de Cardiología, Hospital Puerta de Hierro, Madrid, Spain.
authors: José A
authors: JA
authors: Fernández-Díaz
authors: Servicio de Cardiología, Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors: Raúl
authors: R
authors: Valdesuso-Aguilar
authors: Servicio de Cardiología, Hospital Virgen de la Salud, Toledo, Spain.
authors: José
authors: J
authors: Moreu-Burgos
authors: Servicio de Cardiología, Hospital Juan Ramón Jiménez, Huelva, Spain.
authors: José
authors: J
authors: Díaz-Fernández
mesh_terms: D000368:Aged; D023903:Coronary Restenosis / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D048909:Diabetes Complications / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015607:Stents; D014025:Titanium
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D014025:Titanium; D020123:Sirolimus
keywords: Diabetes mellitus; Everolimus-eluting stent; Reestenosis; Restenosis; Stent bioactivo de titanio; Stent de everolimus; Titanium stent