Effectiveness and Safety of Contemporary Drug-Eluting Stents in Patients With Diabetes Mellitus

Yujin Yang, MD; Junho Hyun, MD; Junghoon Lee, MD; Ju Hyeon Kim, MD; Jeong Bok Lee, PhD; Do-Yoon Kang, MD; Pil Hyung Lee, MD; Jung-Min Ahn, MD; Duk-Woo Park, MD; Seung-Jung Park, MD

JACC: Asia (Sep 2021)

Effectiveness and Safety of Contemporary Drug-Eluting Stents in Patients With Diabetes Mellitus

Yujin Yang, MD,
Junho Hyun, MD,
Junghoon Lee, MD,
Ju Hyeon Kim, MD,
Jeong Bok Lee, PhD,
Do-Yoon Kang, MD,
Pil Hyung Lee, MD,
Jung-Min Ahn, MD,
Duk-Woo Park, MD,
Seung-Jung Park, MD

Affiliations

Yujin Yang, MD: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Junho Hyun, MD: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Junghoon Lee, MD: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Ju Hyeon Kim, MD: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Jeong Bok Lee, PhD: Division of Clinical Epidemiology and Biostatistics, Center for Medical Research and Information, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Do-Yoon Kang, MD: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Pil Hyung Lee, MD: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Jung-Min Ahn, MD: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
Duk-Woo Park, MD: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Address for correspondence: Dr Duk-Woo Park, Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea.
Seung-Jung Park, MD: Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

Journal volume & issue: Vol. 1, no. 2
pp. 173 – 184

Abstract

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Background: Diabetes mellitus (DM) is a well-known risk factor for adverse cardiovascular events in patients receiving percutaneous coronary intervention (PCI). Limited data are available on the relative performance of different types of contemporary drug-eluting stents (DES) for diabetic patients. Objectives: The authors investigated the effectiveness and safety profiles of several contemporary DES in patients with DM in a “real-world” clinical setting. Methods: Among 24,516 patients enrolled in a multicenter, prospective registry, 7,823 patients with DM were treated with 4 contemporary DES: 2,877 with a cobalt chromium everolimus-eluting stent (EES), 789 with a biodegradable polymer biolimus-eluting stent, 2,286 with a platinum chromium-EES, and 1,871 with a Resolute zotarolimus-eluting stent. The primary outcome was target vessel failure (TVF) (a composite of cardiac death, target vessel myocardial infarction, and target vessel revascularization). Results: The median follow-up duration was 2.9 years. Observed 3-year rates of TVF were not significantly different according to different DES types. On multigroup propensity-score analysis, the adjusted HRs for TVF were similar in between-group comparisons: biodegradable polymer biolimus-eluting stent (HR: 0.94; 95% CI: 0.76-1.16; P = 0.57), platinum chromium-EES (HR: 0.94; 95% CI: 0.81-1.09; P = 0.41), and Resolute zotarolimus-eluting stent (HR: 1.01; 95% CI: 0.86-1.18; P = 0.93) compared with the cobalt chromium-EES (reference). This trend was maintained in patients with non–insulin- and insulin-treated DM. Conclusions: In this multicenter clinical-practice PCI registry, no significant between-group differences were found for a 3-year risk of TVF in patients with DM undergoing PCI with various types of contemporary DES. (Evaluation of the First, Second, and New Drug-Eluting Stents in Routine Clinical Practice [IRIS-DES]; NCT01186133)

Published in JACC: Asia

ISSN: 2772-3747 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/jacc-asia

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