title: One-year cardiovascular outcomes of drug-eluting stent versus bare-metal stent implanted in diabetic patients with acute coronary syndrome.
abstract: BACKGROUND
  The outcomes of drug-eluting stent (DES) versus bare-metal stent (BMS) use in patients with diabetic mellitus (DM) and acute coronary syndrome (ACS) are rarely reported in Taiwan. This study aimed to investigate the 1-year cardiovascular outcomes of DESs versus BMSs implanted in Taiwanese patients with DM and ACS.
  
  
  METHODS
  For this study, we collected and analyzed patient information from the database of the Taiwan ACS Full Spectrum registry regarding characteristics and cardiovascular events in participants with DM and ACS who received implantation of either BMS (BMS group) or DES (DES group) from October 2008 to January 2010.
  
  
  RESULTS
  We found that several characteristics significantly varied between the groups. Compared with the BMS group (n = 575), the DES group (n = 199) had significantly lower rates of in-hospital cardiogenic shock (1.5% vs. 4.9%, p = 0.037) and acute renal failure (0.5% vs. 4.5%, p = 0.008), all-cause mortality (5.0% vs. 8.9%, p = 0.048), and major adverse cardiac events (MACEs) at 1 year (11.1% vs. 18.6%, p = 0.006) with an identical target vessel revascularization (TVR) rate (6.0% vs. 7.3%, p = 0.395). The BMS group had significantly higher risk-adjusted all-cause mortality [hazard ratio (HR) = 2.4, 95% confidence interval (CI) 1.0-5.7; p = 0.048] and MACE (HR = 2.2, 95% CI 1.2-3.9; p = 0.011) at 1 year with identical risks of TVR (HR = 1.3, 95% CI 0.6-2.9; p = 0.505) and nonfatal myocardial infarction (HR = 1.5, 95% CI 0.5-4.4; p = 0.478).
  
  
  CONCLUSIONS
  The results of this study support the use of DES over BMS in Taiwanese patients with DM and ACS, providing the clinical benefits of lower rates of total mortality and MACE, and without increased TVR at 1 year in a real-world setting.
authors.affiliation: Cardiovascular Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC; Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Chi-Cheng
authors.initials: CC
authors.lastname: Lai
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan, ROC; Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
authors.forename: Hon-Kan
authors.initials: HK
authors.lastname: Yip
authors.affiliation: Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
authors.forename: Chun-Peng
authors.initials: CP
authors.lastname: Liu
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan, ROC.
authors.forename: Ai-Hsien
authors.initials: AH
authors.lastname: Li
authors.affiliation: Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC.
authors.forename: Kou-Gi
authors.initials: KG
authors.lastname: Shyu
authors.affiliation: Research Services Center for Health Information, Chang Gung University, Taoyuan, Taiwan, ROC.
authors.forename: Shu-Chen
authors.initials: SC
authors.lastname: Chang
authors.affiliation: Cardiovascular Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; College of Health and Nursing, Meiho University, Pingtung, Taiwan, ROC. Electronic address: philipmar0119@gmail.com.
authors.forename: Guang-Yuan
authors.initials: GY
authors.lastname: Mar
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D000328:Adult; D000368:Aged; D048909:Diabetes Complications / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D008670:Metals
keywords: acute coronary syndrome; bare-metal stent; diabetes mellitus; drug-eluting stent; outcome; percutaneous coronary intervention