Document Detail


Comparison of outcomes in patients with insulin-dependent versus non-insulin dependent diabetes mellitus receiving drug-eluting stents (from the first phase of the prospective multicenter German DES.DE registry).
MedLine Citation:
PMID:  21029813     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Drug-eluting stents have been effective in randomized controlled trials, but their safety and efficacy in patients with insulin-dependent diabetes has not been well studied. Baseline clinical and angiographic characteristics and in-hospital and follow-up events were recorded for enrolled patients. From October 2005 and October 2006, 581 patients with insulin-dependent diabetes and 1,078 with non-insulin-dependent diabetes treated with sirolimus- and paclitaxel-eluting stents were enrolled at 98 sites. The composite of death, myocardial infarction, and stroke, defined as major adverse cardiac and cerebrovascular events, as well as target vessel revascularization was used as the primary end point. Multiple logistic regression analysis was used to adjust for confounding parameters. Baseline clinical characteristics were more severe in patients with insulin-dependent diabetes, whereas descriptive characteristics were not unique. At 1-year follow-up, the comparison between the 2 groups revealed significantly higher rates of overall death (7.4% vs 4.6%, p <0.05), target vessel revascularization (15.1% vs 10.4%, p <0.05), and overall stent thrombosis (6.5% vs 4.1%, p <0.05) for insulin-dependent patients, while rates of major adverse cardiac and cerebrovascular events were not significantly different (12.8% vs 9.9%, p = 0.09). These results persisted even after risk adjustment for heterogenous baseline characteristics of the 2 groups. In conclusion, the data generated from the German Drug-Eluting Stent (DES.DE) registry revealed that even with drug-eluting stents, the annual risk for death, target vessel revascularization, and thrombotic events remains higher in patients with insulin-dependent diabetes compared to those with non-insulin-dependent diabetes.
Authors:
Ibrahim Akin; Alexander Bufe; Lars Eckardt; Holger Reinecke; Jochen Senges; Gert Richardt; Karl-Heinz Kuck; Steffen Schneider; Christoph A Nienaber;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study     Date:  2010-09-09
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-29     Completed Date:  2010-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1201-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Internal Medicine I, University Hospital Rostock, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Disease / drug therapy*,  etiology*
Diabetes Mellitus, Type 1 / complications*
Diabetes Mellitus, Type 2 / complications*
Drug-Eluting Stents*
Female
Germany
Humans
Hypoglycemic Agents / therapeutic use
Immunosuppressive Agents / therapeutic use*
Insulin / therapeutic use
Logistic Models
Male
Paclitaxel / administration & dosage,  therapeutic use*
Prospective Studies
Registries
Sirolimus / administration & dosage,  therapeutic use*
Survival Rate
Treatment Outcome
Tubulin Modulators / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 0/Immunosuppressive Agents; 0/Tubulin Modulators; 11061-68-0/Insulin; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus
Investigator
Investigator/Affiliation:
Christoph A Nienaber / ; Karl-Heinz Kuck / ; Christoph Bode / ; Fokko de Haan / ; Gert Richardt / ; Georg Sabin / ; Jochen Senges / ; Sigmund Silber / ; Jürgen Stumpf / ; Ulrich Tebbe / ; Stephan Willich / ; Thomas Fetsch / ; Gabriele Sailer / ; Steffen Schneider / ; Bernhard Meier / ; Ahmed A Khattab / ; Martin G Gottwik / ; Thomas Fetsch / ; Petra Kremer / ; Steffen Schneider /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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