Document Detail


Outcomes of diabetics receiving bare-metal stents versus drug-eluting stents.
MedLine Citation:
PMID:  20882647     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to determine if differences existed in in-hospital outcomes, long-term rates of target vessel revascularization (TVR), and/or long-term mortality trends between patients with diabetes mellitus undergoing percutaneous coronary intervention (PCI) with either a drug-eluting stent(s) (DES) or a bare metal stent(s) (BMS).
BACKGROUND: Short- and long-term clinical outcomes of patients with diabetes mellitus undergoing PCI with DES versus BMS remain inconsistent between randomized-controlled trials (RCTs) and observational studies.
METHODS: Data were collected prospectively on diabetics undergoing PCI with either DES or BMS from January 2000 to June 2008. Demographic information, medical histories, in-hospital outcomes, and long-term TVR and mortality trends were obtained for all patients.
RESULTS: A total of 1,319 patients were included in the study. Diabetics receiving DES had a significant reduction in index admission MACE compared to diabetics receiving BMS. Using multivariable adjustment, after a mean follow-up of 2.5 years (maximum 5 years), diabetics who received DES had a 38% decreased risk of TVR compared to diabetics with BMS [HR 0.62 (95% CI: 0.43-0.90)]; diabetics with DES had an insignificant adjusted improvement in long-term survival compared to diabetics with BMS [HR 0.72 (95% CI: 0.52-1.00)]. These long-term survival and TVR rates were confirmed using propensity scoring.
CONCLUSIONS: The use of DES when compared with BMS among diabetics undergoing PCI is associated with significant improvement in long-term TVR, with an insignificant similar trend in all-cause mortality. The long-term results of this observational study are consistent with prior RCTs after adjusting for confounding variables.
Authors:
Vijay S Ramanath; Jeremiah R Brown; David J Malenka; James T DeVries; Mandeep S Sidhu; John F Robb; John E Jayne; Bruce D Hettleman; Bruce J Friedman; Nathaniel W Niles; Aaron V Kaplan; Craig A Thompson;
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  76     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-30     Completed Date:  2011-01-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  473-81     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley-Liss, Inc.
Affiliation:
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary / adverse effects,  instrumentation*,  mortality
Diabetes Mellitus, Type 1 / complications*,  mortality
Diabetes Mellitus, Type 2 / complications*,  mortality
Drug-Eluting Stents*
Female
Heart Diseases / complications,  mortality,  therapy*
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Metals*
Middle Aged
New England
Propensity Score
Proportional Hazards Models
Prospective Studies
Prosthesis Design
Registries
Risk Assessment
Risk Factors
Stents*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Metals
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 2010 Oct 1;76(4):482-3   [PMID:  20882648 ]

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


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