Safety and efficacy of drug-eluting vs. bare metal stents in patients with diabetes mellitus: long-term follow-up in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)
(2010) In European Heart Journal 31(2). p.177-186- Abstract
- Patients with diabetes mellitus have more extensive coronary artery disease, more disease progression, and restenosis. The use of drug-eluting stents (DES) in these patients is widespread, despite uncertain long-term safety and efficacy. All consecutive patients with diabetes mellitus in Sweden who underwent percutaneous coronary intervention were entered into the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) during 2003-06 with complete follow-up for 1-4 years (median 2.5). Patients who received at least one DES (n = 4754) were compared with those who received only bare metal stents (BMS) (n = 4956) at the index procedure. Combined outcome of death or myocardial infarction (MI) showed no difference for DES vs. BMS,... (More)
- Patients with diabetes mellitus have more extensive coronary artery disease, more disease progression, and restenosis. The use of drug-eluting stents (DES) in these patients is widespread, despite uncertain long-term safety and efficacy. All consecutive patients with diabetes mellitus in Sweden who underwent percutaneous coronary intervention were entered into the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) during 2003-06 with complete follow-up for 1-4 years (median 2.5). Patients who received at least one DES (n = 4754) were compared with those who received only bare metal stents (BMS) (n = 4956) at the index procedure. Combined outcome of death or myocardial infarction (MI) showed no difference for DES vs. BMS, relative risk (RR), 0.91 [95% confidence interval (CI), 0.77-1.06]. Myocardial infarction was significantly less common with DES in patients who received only one stent RR, 0.80 (95% CI, 0.66-0.96). The restenosis rate was 50% lower in DES-treated patients RR, 0.50 (95% CI, 0.35-0.70) and was associated with a higher adjusted RR of MI, RR, 5.03 (95% CI, 4.25-5.97). DES was associated with reduced restenosis rates in all subgroups of diabetic patients with the greatest benefit in stent diameters < 3 mm or stent length > 20 mm. The number of lesions treated with DES to prevent one restenosis ranged from 11 to 47 in various subgroups. This real-life registry study shows that restenosis was halved by DES in diabetic patients with stable or unstable coronary disease, with similar risk of death or MI up to 4 years compared with BMS. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1547535
- author
- Stenestrand, Ulf ; James, Stefan K. ; Lindback, Johan ; Frobert, Ole ; Carlsson, Jorg ; Scherstén, Fredrik LU ; Nilsson, Tage and Lagerqvist, Bo
- organization
- publishing date
- 2010
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Percutaneous coronary intervention, Revascularization, Drug-eluting stent, Mortality, Diabetes mellitus, Outcome, Myocardial infarction
- in
- European Heart Journal
- volume
- 31
- issue
- 2
- pages
- 177 - 186
- publisher
- Oxford University Press
- external identifiers
-
- wos:000273700600014
- scopus:74549191936
- pmid:19903684
- ISSN
- 1522-9645
- DOI
- 10.1093/eurheartj/ehp424
- language
- English
- LU publication?
- yes
- id
- 45bee6ba-0098-4b23-9cd5-dd763fdabf3b (old id 1547535)
- date added to LUP
- 2016-04-01 13:32:38
- date last changed
- 2022-03-21 19:08:25
@article{45bee6ba-0098-4b23-9cd5-dd763fdabf3b,
abstract = {{Patients with diabetes mellitus have more extensive coronary artery disease, more disease progression, and restenosis. The use of drug-eluting stents (DES) in these patients is widespread, despite uncertain long-term safety and efficacy. All consecutive patients with diabetes mellitus in Sweden who underwent percutaneous coronary intervention were entered into the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) during 2003-06 with complete follow-up for 1-4 years (median 2.5). Patients who received at least one DES (n = 4754) were compared with those who received only bare metal stents (BMS) (n = 4956) at the index procedure. Combined outcome of death or myocardial infarction (MI) showed no difference for DES vs. BMS, relative risk (RR), 0.91 [95% confidence interval (CI), 0.77-1.06]. Myocardial infarction was significantly less common with DES in patients who received only one stent RR, 0.80 (95% CI, 0.66-0.96). The restenosis rate was 50% lower in DES-treated patients RR, 0.50 (95% CI, 0.35-0.70) and was associated with a higher adjusted RR of MI, RR, 5.03 (95% CI, 4.25-5.97). DES was associated with reduced restenosis rates in all subgroups of diabetic patients with the greatest benefit in stent diameters < 3 mm or stent length > 20 mm. The number of lesions treated with DES to prevent one restenosis ranged from 11 to 47 in various subgroups. This real-life registry study shows that restenosis was halved by DES in diabetic patients with stable or unstable coronary disease, with similar risk of death or MI up to 4 years compared with BMS.}},
author = {{Stenestrand, Ulf and James, Stefan K. and Lindback, Johan and Frobert, Ole and Carlsson, Jorg and Scherstén, Fredrik and Nilsson, Tage and Lagerqvist, Bo}},
issn = {{1522-9645}},
keywords = {{Percutaneous coronary intervention; Revascularization; Drug-eluting stent; Mortality; Diabetes mellitus; Outcome; Myocardial infarction}},
language = {{eng}},
number = {{2}},
pages = {{177--186}},
publisher = {{Oxford University Press}},
series = {{European Heart Journal}},
title = {{Safety and efficacy of drug-eluting vs. bare metal stents in patients with diabetes mellitus: long-term follow-up in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR)}},
url = {{http://dx.doi.org/10.1093/eurheartj/ehp424}},
doi = {{10.1093/eurheartj/ehp424}},
volume = {{31}},
year = {{2010}},
}