Abstract 14109: Impact of Diabetes Mellitus on Angiographic Outcomes in Patients With Different Drug-Eluting Stents
Background: Percutaneous coronary intervention in diabetes mellitus (DM) patients is associated with higher rates of repeat revascularization and major adverse cardiac events compared with those in non-DM patients. However, no data is currently available to evaluate the effects of different drug-eluting stents on the angiographic outcomes of DM patients.
Methods: From November 2002 to August 2010, 8527 consecutive de novo coronary lesions were treated with drug-eluting stents. We treated 5727 lesions with a sirolimus-eluting stent (SES), 1341 with a paclitaxel-eluting stent (PES), 851 with an everolimus-eluting stent (EES) and 608 with a zotarolimus-eluting stent (ZES). Angiographic follow-up was routinely performed 8 months after successful stent placement (follow-up rate: 81.7%). Of the patients treated with stents, 42% were DM and 12% were insulin-treated patients. Angiographic outcomes were compared among the implanted stent types.
Results: The table shows baseline angiographic characteristics and angiographic outcomes. The binary restenosis rates at 8-month follow-up angiography were 8.3% in non-DM patients, 13.8% in DM patients, and 16.3% in insulin-treated patients. Target lesion revascularization (TLR) rates were 4.7% in non-DM patients, 8.3% in DM patients, and 10.1% in insulin-treated patients. Binary restenosis, target lesion revascularization, and late loss were significantly better in the SES and EES groups than in the PES and ZES groups (p < 0.0001). The SES, PES, and ZES groups had higher restenosis rates and TLR rates in DM patients compared with non-DM patients (p < 0.0001). Late loss, binary restenosis, and TLR in the EES group were unrelated to DM.
Conclusions: Percutaneous coronary intervention in DM patients is associated with worse angiographic outcomes compared with those in non-DM patients. The use of EES could be effective for DM patients.
- © 2011 by American Heart Association, Inc.