What is the clinical evidence from this study?

Study design: Observational. Population: Coronary artery disease (n=6739). Intervention: Drug-eluting stent (DES) vs. Bare metal stent (BMS). Primary outcome: Re-stenosis rate in patients with diabetes mellitus.

What question did this study set out to answer?

To evaluate the impact of drug-eluting stents versus bare metal stents on outcomes in patients with severe coronary disease, particularly focusing on those with diabetes mellitus.

April 1, 2026Open Access

Impact of severe coronary disease associated or not associated with diabetes mellitus on outcome of interventional treatment using stents: Results from HERZ (heart research group of Kanazawa) analyses

Resultado clave

Drug-eluting stents significantly decreased the re-stenosis rate compared with bare metal stents in patients with diabetes mellitus (9.6% vs 21.3%) and those without (9.5% vs 17.1%).

Puntos clave

To evaluate the impact of drug-eluting stents versus bare metal stents on outcomes in patients with severe coronary disease, particularly focusing on those with diabetes mellitus.
Analyzed data from 6739 patients treated with either drug-eluting stents or bare metal stents
Compared re-stenosis rates between patients with and without diabetes mellitus
Evaluated event-free survival outcomes after stenting, particularly in left main coronary artery disease
Drug-eluting stents significantly reduced re-stenosis rates in both diabetic and non-diabetic patients
Re-stenosis rate was higher in diabetic patients when using bare metal stents
No significant difference in event-free survival for left main coronary artery patients between stent types

Diseño del estudio

Tipo

Observational (n=6,739)

PICO estructurado

Does percutaneous coronary intervention using a drug-eluting stent reduce re-stenosis and MACE compared to a bare metal stent in patients with coronary artery disease with or without diabetes mellitus?

Población

6739 patients with coronary artery disease undergoing percutaneous coronary intervention (mean age 68.9 years, 5103 men)

Intervención

Percutaneous coronary intervention using a drug-eluting stent (DES)

Comparador

Percutaneous coronary intervention using a bare metal stent (BMS)

Resultado

Re-stenosis rate and Major Adverse Cardiovascular Events (MACE)composite

Drug-eluting stents significantly reduce re-stenosis rates compared to bare metal stents in real-world patients undergoing PCI, with pronounced benefits in patients with diabetes mellitus.

Resultado numérico

Tasa de eventos absoluta: 9.6% vs 21.3%

Resumen

Percutaneous coronary intervention (PCI) using a drug-eluting stent (DES) leads to less re-stenosis than PCI using a bare metal stent (BMS), however there is still controversy whether use of a DES for severe coronary disease leads to an acceptable outcome in patients with diabetes mellitus (DM). In this study 8159 lesions were treated in 6739 patients (mean age 68.9 years) with coronary artery disease. Use of a DES significantly decreased the re-stenosis rate compared with BMS in both DM (9.6% versus 21.3%) and non-DM (9.5% versus 17.1%) patients. The re-stenosis rate was significantly higher in DM than in non-DM patients in the BMS group but not in the DES group. There was no statistically significant difference in event-free survival after stenting of patients with left main coronary artery (LMCA) disease between the BMS and DES groups. It was concluded that, compared with BMS, DES reduced re-stenosis in patients with DM, however, we advise careful treatment after using DES for severe coronary disease, including LMCA lesions, in patients with DM. © 2011 Field House Publishing LLP.

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