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Drug-eluting stents versus bare-metal stents in diabetic patients with ST-segment elevation acute myocardial infarction : a pooled analysis of individual patient data from seven randomized trials

Iijima, Raisuke and Byrne, Robert A. and Dibra, Alban and Ndrepepa, Gjin and Spaulding, Christian and Laarman, Gerrit J. and Menichelli, Maurizio and Valgimigli, Marco and Di Lorenzo, Emilio and Kaiser, Christoph and Tierala, Ilkka and Mehilli, Julinda and Suttorp, Maarten J. and Violini, Roberto and Schömig, Albert and Kastrati, Adnan. (2009) Drug-eluting stents versus bare-metal stents in diabetic patients with ST-segment elevation acute myocardial infarction : a pooled analysis of individual patient data from seven randomized trials. Revista española de cardiologia, Vol. 62, H. 4. pp. 354-364.

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Official URL: http://edoc.unibas.ch/dok/A6007471

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Abstract

INTRODUCTION AND OBJECTIVES: The performance of drug-eluting stents (DESs) in high-risk patients with diabetes and acute ST-elevation myocardial infarction (STEMI) who have undergone primary angioplasty has not been previously studied. The objective was to evaluate the efficacy and safety of DESs in diabetic patients with STEMI. METHODS: We performed a pooled analysis of individual patient data from seven randomized trials that compared DESs (i.e., sirolimus- or paclitaxel-eluting stents) with bare-metal stents (BMSs) in patients with STEMI. The analysis involved 389 patients with diabetes mellitus from a total of 2476 patients. The outcomes of interest were target-lesion revascularization, stent thrombosis, death and the composite endpoint of death or recurrent myocardial infarction during a follow-up of 12-24 months. RESULTS: Overall, 206 diabetic patients received a DES and 183, a BMS. The risk of target-lesion revascularization was significantly lower in patients treated with a DES compared to those treated with a BMS (hazard ratio [HR] 0.44, 95% confidence interval [CI] 0.23-0.88; P=.02). There was no significant difference in the risk of stent thrombosis between those treated with a DES or a BMS (HR 0.33, 95% CI 0.09-1.13; P=.08). Similarly, the risk of the combined endpoint of death or myocardial infarction was not significantly different between patients treated with a DES or a BMS (HR 0.64, 95% CI 0.36-1.13; P=.12). CONCLUSIONS: Compared with BMSs, DES use improved clinical outcomes in diabetic patients undergoing primary angioplasty for STEMI: the need for reintervention was reduced, with no increase in mortality or myocardial infarction.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie
UniBasel Contributors:Kaiser, Christoph A.
Item Type:Article, refereed
Article Subtype:Further Journal Contribution
Bibsysno:Link to catalogue
ISSN:0300-8932
Note:Publication type according to Uni Basel Research Database: Journal item
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Last Modified:18 Jul 2014 09:10
Deposited On:18 Jul 2014 09:10

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