Abstract
Background: There is an ongoing debate on the optimal drug-eluting stent (DES) in diabetic patients with coronary artery disease. We addressed this issue by making a synthesis of the available evidence on the relative long-term efficacy and safety of sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) in these patients. Methods: Individual patient data were analyzed from 6 randomized trials specifically designed to compare SES with PES in diabetic patients. In total, 1183 patients were followed up for a median of 3.9 years (25th, 75th percentiles 3.4-4.5 years). The primary efficacy end point was target lesion revascularization (TLR). The composite of death and myocardial infarction (MI) was the primary safety end point. Stent thrombosis was a secondary end point. Overall hazard ratios (HRs) with 95% CIs were calculated as summary estimates. Results: No significant heterogeneity was seen across the 6 randomized trials for all analyzed events. Sirolimus-eluting stent was associated with a significant reduction in the risk of TLR (HR 0.65 [0.47-0.91], P =.01). No significant differences were observed regarding the risk of death or MI (HR 1.04 [0.74-1.45], P =.83) and stent thrombosis (HR 1.00 [0.31-3.30], P =.67). Mortality was also not affected by the type of DES (HR 0.95 [0.65-1.39], P =.79). Conclusions: In diabetic patients with coronary artery disease, SES leads to a sustained reduction in the risk of TLR compared with PES. Both these DES types are, however, comparable with respect to the risk of stent thrombosis, MI, or death over long-term follow-up.
| Original language | English |
|---|---|
| Pages (from-to) | 740-747 |
| Number of pages | 8 |
| Journal | American Heart Journal |
| Volume | 162 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2011 Oct 1 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
A meta-analysis of specifically designed randomized trials of sirolimus-eluting versus paclitaxel-eluting stents in diabetic patients with coronary artery disease. / Kufner, Sebastian; De Waha, Antoinette; Tomai, Fabrizio; Park, Seong Wook; Lee, Seung Whan; Lim, Do-Sun; Kim, Moo Hyun; Galloe, Anders M.; Maeng, Michael; Briguori, Carlo; Dibra, Alban; Schömig, Albert; Kastrati, Adnan.
In: American Heart Journal, Vol. 162, No. 4, 01.10.2011, p. 740-747.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A meta-analysis of specifically designed randomized trials of sirolimus-eluting versus paclitaxel-eluting stents in diabetic patients with coronary artery disease
AU - Kufner, Sebastian
AU - De Waha, Antoinette
AU - Tomai, Fabrizio
AU - Park, Seong Wook
AU - Lee, Seung Whan
AU - Lim, Do-Sun
AU - Kim, Moo Hyun
AU - Galloe, Anders M.
AU - Maeng, Michael
AU - Briguori, Carlo
AU - Dibra, Alban
AU - Schömig, Albert
AU - Kastrati, Adnan
PY - 2011/10/1
Y1 - 2011/10/1
N2 - Background: There is an ongoing debate on the optimal drug-eluting stent (DES) in diabetic patients with coronary artery disease. We addressed this issue by making a synthesis of the available evidence on the relative long-term efficacy and safety of sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) in these patients. Methods: Individual patient data were analyzed from 6 randomized trials specifically designed to compare SES with PES in diabetic patients. In total, 1183 patients were followed up for a median of 3.9 years (25th, 75th percentiles 3.4-4.5 years). The primary efficacy end point was target lesion revascularization (TLR). The composite of death and myocardial infarction (MI) was the primary safety end point. Stent thrombosis was a secondary end point. Overall hazard ratios (HRs) with 95% CIs were calculated as summary estimates. Results: No significant heterogeneity was seen across the 6 randomized trials for all analyzed events. Sirolimus-eluting stent was associated with a significant reduction in the risk of TLR (HR 0.65 [0.47-0.91], P =.01). No significant differences were observed regarding the risk of death or MI (HR 1.04 [0.74-1.45], P =.83) and stent thrombosis (HR 1.00 [0.31-3.30], P =.67). Mortality was also not affected by the type of DES (HR 0.95 [0.65-1.39], P =.79). Conclusions: In diabetic patients with coronary artery disease, SES leads to a sustained reduction in the risk of TLR compared with PES. Both these DES types are, however, comparable with respect to the risk of stent thrombosis, MI, or death over long-term follow-up.
AB - Background: There is an ongoing debate on the optimal drug-eluting stent (DES) in diabetic patients with coronary artery disease. We addressed this issue by making a synthesis of the available evidence on the relative long-term efficacy and safety of sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) in these patients. Methods: Individual patient data were analyzed from 6 randomized trials specifically designed to compare SES with PES in diabetic patients. In total, 1183 patients were followed up for a median of 3.9 years (25th, 75th percentiles 3.4-4.5 years). The primary efficacy end point was target lesion revascularization (TLR). The composite of death and myocardial infarction (MI) was the primary safety end point. Stent thrombosis was a secondary end point. Overall hazard ratios (HRs) with 95% CIs were calculated as summary estimates. Results: No significant heterogeneity was seen across the 6 randomized trials for all analyzed events. Sirolimus-eluting stent was associated with a significant reduction in the risk of TLR (HR 0.65 [0.47-0.91], P =.01). No significant differences were observed regarding the risk of death or MI (HR 1.04 [0.74-1.45], P =.83) and stent thrombosis (HR 1.00 [0.31-3.30], P =.67). Mortality was also not affected by the type of DES (HR 0.95 [0.65-1.39], P =.79). Conclusions: In diabetic patients with coronary artery disease, SES leads to a sustained reduction in the risk of TLR compared with PES. Both these DES types are, however, comparable with respect to the risk of stent thrombosis, MI, or death over long-term follow-up.
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U2 - 10.1016/j.ahj.2011.07.003
DO - 10.1016/j.ahj.2011.07.003
M3 - Article
VL - 162
SP - 740
EP - 747
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 4
ER -