Comparison of clinical outcomes between first-generation and second-generation drug-eluting stents in type 2 diabetic patients

Han Saem Jeong, Jae Young Cho, Eun Ji Kim, Cheol Woong Yu, Chul Min Ahn, Jae Hyoung Park, Soon Jun Hong, Do-Sun Lim

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

BACKGROUND: Drug-eluting stent (DES) implantation has significantly reduced the risk of restenosis and major adverse cardiac event (MACE) rates compared with bare-metal stents in type 2 diabetic patients. Differences in outcomes between the first-generation and second-generation DESs in diabetic patients, however, have yet to be evaluated. AIM: We compared MACEs after second-generation DES implantation compared with those of first-generation stents in diabetic patients. METHODS AND RESULTS: This single-center prospective cohort study compared first-generation DES (n=654) and second-generation DES (n=339) implantation in type 2 diabetic patients by propensity score matching. The primary outcome was the occurrence of MACEs, defined as a composite of all-cause death, nonfatal myocardial infarction, and target vessel revascularization. The rate of MACEs was lower in the second-generation DES group after 2 years of follow-up (3.3 vs. 10.0%, P<0.001). Kaplan-Meier analysis showed higher MACE-free survival in diabetic patients in the second-generation DES group (log-rank P<0.001). In a Cox regression analysis, first-generation DES (hazard ratio=3.60, 95% confidence interval, 2.03-6.37, P<0.001) was an independent predictor for MACEs. CONCLUSION: In type 2 diabetic patients, second-generation DES implantation resulted in lower MACEs compared with first-generation DESs, primarily because of lower target lesion and vessel revascularization rates.

Original languageEnglish
Pages (from-to)676-683
Number of pages8
JournalCoronary Artery Disease
Volume24
Issue number8
DOIs
Publication statusPublished - 2013 Dec 1

Fingerprint

Drug-Eluting Stents
Stents
Propensity Score
Kaplan-Meier Estimate
Disease-Free Survival
Cause of Death
Cohort Studies
Metals
Myocardial Infarction
Regression Analysis
Prospective Studies
Confidence Intervals

Keywords

  • diabetes
  • drug-eluting stents
  • major adverse cardiac event

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparison of clinical outcomes between first-generation and second-generation drug-eluting stents in type 2 diabetic patients. / Jeong, Han Saem; Cho, Jae Young; Kim, Eun Ji; Yu, Cheol Woong; Ahn, Chul Min; Park, Jae Hyoung; Hong, Soon Jun; Lim, Do-Sun.

In: Coronary Artery Disease, Vol. 24, No. 8, 01.12.2013, p. 676-683.

Research output: Contribution to journalArticle

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AU - Hong, Soon Jun

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N2 - BACKGROUND: Drug-eluting stent (DES) implantation has significantly reduced the risk of restenosis and major adverse cardiac event (MACE) rates compared with bare-metal stents in type 2 diabetic patients. Differences in outcomes between the first-generation and second-generation DESs in diabetic patients, however, have yet to be evaluated. AIM: We compared MACEs after second-generation DES implantation compared with those of first-generation stents in diabetic patients. METHODS AND RESULTS: This single-center prospective cohort study compared first-generation DES (n=654) and second-generation DES (n=339) implantation in type 2 diabetic patients by propensity score matching. The primary outcome was the occurrence of MACEs, defined as a composite of all-cause death, nonfatal myocardial infarction, and target vessel revascularization. The rate of MACEs was lower in the second-generation DES group after 2 years of follow-up (3.3 vs. 10.0%, P<0.001). Kaplan-Meier analysis showed higher MACE-free survival in diabetic patients in the second-generation DES group (log-rank P<0.001). In a Cox regression analysis, first-generation DES (hazard ratio=3.60, 95% confidence interval, 2.03-6.37, P<0.001) was an independent predictor for MACEs. CONCLUSION: In type 2 diabetic patients, second-generation DES implantation resulted in lower MACEs compared with first-generation DESs, primarily because of lower target lesion and vessel revascularization rates.

AB - BACKGROUND: Drug-eluting stent (DES) implantation has significantly reduced the risk of restenosis and major adverse cardiac event (MACE) rates compared with bare-metal stents in type 2 diabetic patients. Differences in outcomes between the first-generation and second-generation DESs in diabetic patients, however, have yet to be evaluated. AIM: We compared MACEs after second-generation DES implantation compared with those of first-generation stents in diabetic patients. METHODS AND RESULTS: This single-center prospective cohort study compared first-generation DES (n=654) and second-generation DES (n=339) implantation in type 2 diabetic patients by propensity score matching. The primary outcome was the occurrence of MACEs, defined as a composite of all-cause death, nonfatal myocardial infarction, and target vessel revascularization. The rate of MACEs was lower in the second-generation DES group after 2 years of follow-up (3.3 vs. 10.0%, P<0.001). Kaplan-Meier analysis showed higher MACE-free survival in diabetic patients in the second-generation DES group (log-rank P<0.001). In a Cox regression analysis, first-generation DES (hazard ratio=3.60, 95% confidence interval, 2.03-6.37, P<0.001) was an independent predictor for MACEs. CONCLUSION: In type 2 diabetic patients, second-generation DES implantation resulted in lower MACEs compared with first-generation DESs, primarily because of lower target lesion and vessel revascularization rates.

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