Abstract 2533: Paclitaxel-Eluting versus Sirolimus-Eluting Stents in Diabetes Mellitus
Background: Diabetes is a powerful predictor of adverse events in patients undergoing percutaneous coronary intervention. Drug-eluting stents (DES) reduce restenosis rates in diabetics versus bare metal stents. Randomized trials have resulted in ongoing controversy regarding which DES may provide greater benefit among diabetic patients. Accordingly, we compared the safety and efficacy of sirolimus-eluting stents (SES) versus paclitaxel-eluting stents (PES) among diabetic patients in a contemporary registry.
Methods: Using the National Heart, Lung, and Blood Institute Dynamic Registry, we evaluated one-year outcomes of diabetic patients undergoing PCI with SES (n=678) and PES (n=327).
Results: Clinical and demographic characteristics, including age, body-mass index, insulin use, LV function, and aspirin/clopidogrel use post-procedure, did not differ significantly between the groups except that PES-treated patients had a greater frequency of hypertension and hyperlipidemia. No differences in lesion characteristics or procedural success were present. At one year follow-up, no significant differences were observed between PES and SES (figure⇓). PES- and SES-treated patients had similar rates of death (5.8% vs. 4.4%, p=0.42), death and MI (10.1% vs. 9.0%, p=0.60), repeat revascularization (13.4% vs. 11.8%, p=0.42), and stent thrombosis (1.3% vs. 0.9%, p=0.62). These results did not change in the subset of patients in whom 2-year follow-up was available.
Conclusions: PES and SES are equally efficacious and have similar safety profiles in diabetic patients undergoing PCI.