Abstract 3348: TAXUS Liberté Inhibits the Effect of Diabetes on Restenosis: A Pooled Analysis of the TAXUS ATLAS Program
Background: Diabetics suffer from accelerated atherosclerosis, co-morbidities and an increased risk of restenosis. Paclitaxel is hypothesized to inhibit restenosis even in the presence of insulin resistance. To determine the effect of the next-generation TAXUS Liberté (TL) stent on diabetics with a broad spectrum of lesions, we conducted a pooled analysis of the TAXUS ATLAS Workhorse, Small Vessel and Long Lesion studies.
Methods: The TAXUS ATLAS trials are multi-center, prospective, single-arm studies enrolling 1282 pts (918 non-diabetics and 364 diabetics) with de novo coronary lesions ranging from 2.2–4.0 mm in diameter and 10–34 mm in length (by visual estimate). A comparative analysis between diabetics and non-diabetics was performed for clinical outcomes with and without propensity adjustment.
Results: Diabetics had more co-morbidities than non-diabetics, with a higher frequency of hyperlipidemia, hypertension, heart failure, previous revascularization and renal disease. Aside from smaller diameter vessels in diabetics, lesion characteristics were similar between the groups. Although there were slight differences in MACE, TLR and TVR-Remote at 9m, following propensity adjustment for baseline characteristics, outcomes were very similar between the groups. Furthermore, there were no differences in late loss, % diameter stenosis, or neointimal proliferation between the groups, regardless of propensity adjustment.
Conclusions: Similar outcomes with TL were observed for both diabetics and non-diabetics, suggesting that TL attenuates the effect of diabetes on restenosis. The new, thin-strut TL stent designed specifically for improved deliverability and better drug distribution is a promising treatment option for coronary artery disease in diabetics.