RT Journal Article
SR Electronic
T1 Head-to-Head Comparison of Sirolimus- and Paclitaxel-Eluting Stent in the Same Diabetic Patient With Multiple Coronary Artery Lesions
JF Diabetes Care
JO Diabetes Care
FD American Diabetes Association
SP 15
OP 19
DO 10.2337/dc07-1377
VO 31
IS 1
A1 Tomai, Fabrizio
A1 Reimers, Bernhard
A1 De Luca, Leonardo
A1 Galassi, Alfredo R.
A1 Gaspardone, Achille
A1 Ghini, Anna S.
A1 Ferrero, Valeria
A1 Favero, Luca
A1 Gioffrè, Gaetano
A1 Prati, Francesco
A1 Tamburino, Corrado
A1 Ribichini, Flavio
YR 2008
UL http://care.diabetesjournals.org/content/31/1/15.abstract
AB OBJECTIVE—It is still controversial whether sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) are equally effective in patients with diabetes. In these patients, multiple individual variables may be responsible for neointimal hyperplasia, thus making difficult the comparison of the two drug-eluting stents (DES). RESEARCH DESIGN AND METHODS—We designed a prospective, randomized study to compare the efficacy in prevention of restenosis of SES and PES, both implanted in the same diabetic patient with multiple de novo coronary artery lesions undergoing elective percutaneous coronary intervention. We enrolled 60 patients with diabetes with at least two significant de novo angiographic stenoses in different coronary segments. The primary end point was in-stent late luminal loss (LLL) at 8-month angiographic follow-up. RESULTS—A total of 120 lesions were successfully treated with the randomly assigned DES (SES, n = 60; PES, n = 60). In-stent LLL was lower in the SES than in the PES group (0.26 ± 0.4 vs. 0.50 ± 0.6 mm; P = 0.01). Coronary lesions treated with SES presented a reduced in-stent LLL in 40 (68%) patients, while PES resulted in a lower in-stent LLL in 19 (32%) patients (P = 0.0002). At multivariable analysis, the type of DES implanted was the only independent predictor of in-stent LLL (odds ratio 2.3 [95% CI 1.1–5.0]; P = 0.03). CONCLUSIONS—SES directly compared with PES in the same diabetic patient is associated with a decrease in the extent of in-stent LLL at 8 months, suggesting a reduced risk of restenosis.