Key result
Percutaneous coronary intervention with drug-eluting stents compared to bare-metal stents in older patients with type 2 diabetes significantly reduced major adverse cardiovascular events (36% vs 61%).
Why the study?
Does PCI with drug-eluting stents reduce major adverse cardiovascular events compared to bare-metal stents in elderly patients with coronary heart disease and type 2 diabetes?
Cohort (n=120)
No
Does PCI with drug-eluting stents reduce major adverse cardiovascular events compared to bare-metal stents in elderly patients with coronary heart disease and type 2 diabetes?
In elderly patients with type 2 diabetes, PCI with drug-eluting stents significantly reduces the incidence of myocardial infarction and target lesion restenosis compared to bare-metal stents.
DES use was associated with fewer MIs and MACE than BMS in older diabetics; leaves open whether RCTs would confirm benefit before practice change.
OBJECTIVE: Our aim was to compare results of the percutaneous coronary intervention (PCI) with drug elutingstent (DES) and bare metal stent (BMS) in older patients with coronary heart disease (CHD) and diabetes mellitus (DM) type 2. METHODS: Patients (> 65 years) with DM type 2 were divided into two groups: the 1st group--58 patients after PCI with DES, the 2nd group--62 patients after PCI with BMS. The average follow-up period was 32.6 ± 8.0 months. The end-points of the study were death, non-fatal myocardial infarction and restenosis of the target stenosis. RESULTS: Endovascular treatment of patients older than 65 years with DM is highly effective and safe despite the complexity of coronary lesions. There are no significant differences in the rate of early (hospital) complications in two groups. Also, we did notfind differences in three-year mortality between the groups. But the incidence of myocardial infarction in the groups with DES and BMS was 9% and 18% respectively (p = 0.039). Major adverse cardiovascular events (death, myocardial infarction and restenosis of the target stenosis) frequency was also lower in the group with DES compared to BMS (36% and 61% respectively, p = 0.001). CONCLUSION: Endovascular treatment of patients older than 65 years with DM type 2 is a highly effective and safe method despite the complexity of coronary lesions. PCI with DES compared to BMS in older patients with DM is associated with improvement of medium-term results and decreases the number of cardiovascular events.
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Sigaev et al. (2015) conducted a cohort in Coronary heart disease and type 2 diabetes mellitus (n=120). Percutaneous coronary intervention with drug-eluting stent vs. Percutaneous coronary intervention with bare-metal stent was evaluated on Major adverse cardiovascular events (death, myocardial infarction, and target lesion restenosis) (p=0.001). Percutaneous coronary intervention with drug-eluting stents compared to bare-metal stents in older patients with type 2 diabetes significantly reduced major adverse cardiovascular events (36% vs 61%).
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