title: Comparison of 2-year outcomes between zotarolimus-eluting and everolimus-eluting new-generation cobalt-chromium alloy stents in real-world diabetic patients.
abstract: BACKGROUND
  To date, it remains unknown whether different types of new-generation drug-eluting stents have a differential impact on long-term outcomes in diabetic patients.
  
  
  RESULTS
  In this historical cohort study (two Italian centers), we analyzed 400 diabetic patients with 553 coronary lesions treated with new-generation CoCr zotarolimus-eluting stents (R-ZES: 136 patients, 196 lesions) or everolimus-eluting stents (EES: 264 patients, 357 lesions) between October 2006 and August 2012. Primary endpoint was the occurrence of major adverse cardiac events (MACE) over a 2-year follow-up period. MACE was defined as all-cause mortality, any myocardial infarction (MI) and/or target lesion revascularization (TLR). Multivessel revascularization, intervention for restenotic lesion and use of intravascular ultrasound were significantly higher in the R-ZES group, whereas small stent (≤2.5 mm) deployment was significantly higher in the EES group. At 2-year follow-up, there was no significant difference in occurrence of MACE (R-ZES vs EES: 22.8% vs 18.9%, P = 0.39). Similarly, no significant differences were observed in the composite endpoint of all-cause mortality/MI (10.0% vs 10.3%, P = 0.86) or TLR (12.4% vs 7.4%, P = 0.11). Adjustment for confounders and baseline propensity-score matching did not alter the aforementioned associations.
  
  
  CONCLUSIONS
  After 2 years of follow up similar outcomes (MACE, all-cause mortality/MI, TLR) were observed in real-world diabetic patients, including those with complex lesions and patient characteristics, treated with R-ZES and EES.
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.|Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.|Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Miyazaki
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.|Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.|Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.|Physiology and Disease Prevention, National Heart and Lung Institute, Imperial College London, London, United Kingdom.
authors.forename: Vasileios F
authors.initials: VF
authors.lastname: Panoulas
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.|Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Sakiko
authors.initials: S
authors.lastname: Miyazaki
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.|Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Charis
authors.initials: C
authors.lastname: Costopoulos
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.|Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Sato
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.|Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Toru
authors.initials: T
authors.lastname: Naganuma
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.|Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kawamoto
authors.affiliation: Department of Cardiovascular Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
authors.affiliation: Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.|Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D000368:Aged; D002858:Chromium Alloys / Q000494:pharmacology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D003920:Diabetes Mellitus; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011474:Prosthesis Design; D012189:Retrospective Studies; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000494:pharmacology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002858:Chromium Alloys; D007166:Immunosuppressive Agents; D000068338:Everolimus; C489443:zotarolimus; D020123:Sirolimus
keywords: diabetes mellitus; drug eluting stents (DES); percutaneous coronary intervention (PES)