Key Points
- Evaluate the 2-year effectiveness and safety of drug-eluting stents compared with bare metal stents in routine clinical practice among diabetic patients with de novo coronary lesions.
- Analyzed 2-year prospective registry data from 1,648 diabetic patients undergoing percutaneous coronary intervention across 13 hospitals in Emilia-Romagna, Italy (2002–2004).
- Compared outcomes between patients treated exclusively with bare metal stents (n=1,089) or drug-eluting stents (n=559).
- Evaluated major adverse cardiac events, target vessel revascularization, and stent thrombosis using propensity score adjustment and Cox proportional hazards regression.
- Unadjusted 2-year major adverse cardiac events were lower in the drug-eluting stent group compared with bare metal stents (22.5% vs 28.1%; P=0.01).
- After propensity score adjustment, target vessel revascularization was significantly lower with drug-eluting stents (11.6% vs 15.0%; HR 0.66, 95% CI 0.46 to 0.96; P=0.041), with benefits confined to non-insulin-dependent diabetics.
- Two-year angiographic stent thrombosis occurred in 1.5% of drug-eluting stent patients and 0.7% of bare metal stent patients (P=0.18).
Structured PICO
Do drug-eluting stents reduce major adverse cardiac events compared to bare metal stents in diabetic patients with de novo coronary lesions?
PPopulation1,648 diabetic patients with de novo coronary lesions (27% insulin dependent, 83% multivessel coronary disease) enrolled in a prospective multicenter registry
IInterventionDrug-eluting stents (DES) alone
CComparatorBare metal stents alone
OOutcomeMajor adverse cardiac events (composite of all-cause mortality, nonfatal myocardial infarction, and target vessel revascularization) at 2 yearscomposite
In a real-world registry of diabetic patients, the use of drug-eluting stents was associated with a moderate reduction in 2-year target vessel revascularization compared to bare metal stents, primarily benefiting non-insulin-dependent patients.