Document Detail


Impact of insulin-treated diabetes and hemodialysis on long-term clinical outcomes following sirolimus-eluting stent deployment. Insights from a sub-study of the Cypher Stent Japan Post-Marketing Surveillance(Cypher J-PMS) Registry.
MedLine Citation:
PMID:  21041974     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Long-term clinical outcomes of diabetes mellitus (DM) patients who underwent drug-eluting stent deployment has not well investigated.
METHODS AND RESULTS: A total of 2,050 cases were enrolled consecutively from 50 sites in Japan into the Cypher stent Japan Post-Marketing Surveillance (Cypher J-PMS) registry, and the 3-year outcomes of DM patients were analyzed. Subjects were divided into 2 groups based on the treatment of DM (insulin-treated diabetes (IT) group, n=207; and non insulin-treated diabetes (NIT) group, n=682). Major adverse cardiac event (MACE) rates in the IT group and the NIT group were 26.0% and 14.5% at 3 years, respectively (P<0.001). There were no significant differences in stent thrombosis rates (definite and probable by Academic Research Consortium (ARC) definition) (0% and 1.08%, respectively). Multivariate analysis suggested that hemodialysis and insulin-treated DM were independent predictors for MACE, and insulin-treated DM, hemodialysis and long lesions were strong independent predictors for target-lesion revascularization (TLR).
CONCLUSIONS: Hemodialysis and insulin-treated DM were strong independent predictors of mortality and TLR in DM patients. These results might suggest that special attention to patients with hemodialysis and insulin-treated DM is warranted in the setting of sirolimus-eluting stent deployment for DM patients.
Authors:
Masato Nakamura; Hiroyoshi Yokoi; Yuji Hamazaki; Masato Watarai; Mikihiro Kijima; Kazuaki Mitsudo;
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2010-10-28
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-12-02     Completed Date:  2011-03-09     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  2592-7     Citation Subset:  IM    
Affiliation:
Toho University Ohashi Medical Center, Tokyo, Japan. masato@oha.toho-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Diabetes Complications / mortality*,  therapy
Drug-Eluting Stents*
Female
Follow-Up Studies
Heart Diseases / etiology,  mortality*,  therapy
Humans
Hypoglycemic Agents / administration & dosage*
Immunosuppressive Agents / pharmacology*
Insulin / administration & dosage*
Japan
Male
Middle Aged
Product Surveillance, Postmarketing
Registries*
Renal Dialysis*
Sirolimus / pharmacology*
Thrombosis / etiology,  mortality*
Time Factors
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 0/Immunosuppressive Agents; 0/Insulin; 53123-88-9/Sirolimus

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


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