Efficacy of Drug-Eluting Stents in Diabetic Patients Admitted with ST-Elevation Myocardial Infarctions Treated with Primary Percutaneous Coronary Intervention
Key result
DES linked to ~69% lower risk of 1-year major events versus BMS in diabetic STEMI.
- OR 0.31
- 95% CI 0.2-0.6
- P<0.01
- n=8,356
Why the study?
Diabetic patients experience higher adverse ischemic event and mortality rates after PCI for acute myocardial infarction, suggesting they might derive greater benefit from modern-generation DES.
Does the use of drug-eluting stents reduce adverse ischemic events and mortality compared to bare-metal stents in diabetic patients admitted with STEMI undergoing primary PCI?
Population
8356 STEMI patients undergoing emergency PCI and stent implantation in the Bremen STEMI registry
Comparison
BMS vs DES in diabetic patients, with non-diabetic patients as controls
Design
Registry-based cohort study
Follow-up
One year
Authors
Discussion
Loading...
Member takes
Implication
May support DES over BMS for ischemic events in diabetic STEMI; leaves open randomized confirmation and mortality effects.
Study Design
Type
Cohort (n=8,356)
Structured PICO
Does the use of drug-eluting stents reduce adverse ischemic events and mortality compared to bare-metal stents in diabetic patients admitted with STEMI undergoing primary PCI?
P
Population
8,356 patients admitted with ST-elevation-myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI) and stent implantation documented between 2006 and 2019 in the Bremen STEMI registry (1,554 diabetics and 6,802 non-diabetics).
I
Intervention
Drug-eluting stents (DES)
C
Comparator
Bare-metal stents (BMS)
O
Outcome
Composite of in-stent thrombosis, myocardial re-infarction or additional target lesion revascularization at one yearcomposite
Main Result
Effect estimate: OR 0.31 (95% CI 0.2-0.6)
p-value: p=< 0.01
In diabetic patients presenting with STEMI, the use of drug-eluting stents significantly reduces 1-year ischemic events compared to bare-metal stents, effectively lowering their risk to match that of non-diabetic patients.
Cite This Study
Schmucker et al. (2021) conducted a cohort in ST-elevation myocardial infarction (STEMI) and diabetes (n=8,356). Drug-eluting stents (DES) vs. Bare-metal stents (BMS) was evaluated on Combination of in-stent thrombosis, myocardial re-infarction or additional target lesion revascularization at one year (OR 0.31, 95% CI 0.2-0.6, p=< 0.01). Drug-eluting stents reduced 1-year in-stent thrombosis, re-infarction, or target lesion revascularization in diabetic STEMI patients versus bare-metal stents (OR 0.31; 95% CI 0.2-0.6; p<0.01).