Coronary Stents in Diabetic Patients: State of the Knowledge.
This review article aims to summarize the findings of the most relevant research that compared the use of paclitaxel vs. "limus" based drug eluting stent (DES) in diabetic patients and to define the current state of knowledge with new stent technologies in this patient population.



Since drug eluting stents (DES) were introduced, it has been of great interest to establish whether paclitaxel or sirolimus eluting stents have the same safety and efficacy features for patients with coronary artery disease. The answer to this question is particularly relevant for diabetic patients. Several randomized trials, registry-based studies, and meta-analyses have assessed the performance of these different DES in diabetic patients. The most recently published data favors limus over paclitaxel DES in diabetic patients, but most of these studies compared first vs. second generation DES with the inherent caveats of comparing different platforms, alloys, and drug delivery vehicles. In this literature review, we found that there is robust evidence favoring the use of DES over bare metal stents in diabetic patients with coronary artery disease. We also found that the current state of knowledge is that the everolimus eluting stents have better safety and efficacy than paclitaxel eluting stents in diabetic patients and hence should be the preferred choice. New revascularization strategies including bio-absorbable scaffolds, polymer free stents, and bio-degradable polymers are being studied in diabetic patients with encouraging results.
Interventional Cardiology, New York Presbyterian Hospital & Columbia University Medical Center, 161 Fort Washington Avenue 6th Floor, New York, NY, 10032, USA. psc2148@columbia.cumc.edu.|Interventional Cardiology, "Rabin Medical Center" & "Sackler" School of Medicine, Tel Aviv University, Tel Aviv, Israel. psc2148@columbia.cumc.edu.
Pablo
P
Codner
Division of Cardiovascular Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, USA.|Veterans Affairs Medical Center, Ann Arbor, MI, USA.
Hitinder Singh
HS
Gurm
Interventional Cardiology, New York Presbyterian Hospital & Columbia University Medical Center, 161 Fort Washington Avenue 6th Floor, New York, NY, 10032, USA.
Apurva
A
Motivala
D003327:Coronary Disease / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000628:therapy*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017239:Paclitaxel / Q000627:therapeutic use*; D020123:Sirolimus / Q000627:therapeutic use*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D000068338:Everolimus; D017239:Paclitaxel; D020123:Sirolimus
Diabetes mellitus; Drug eluting stent; In stent restenosis; Paclitaxel eluting stent; Sirolimus eluting stent; Target vessel revascularization