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Mass-DAC registry: Lower mortality with drug-eluting vs bare metal stents in patients with diabetes
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Patients with diabetes may derive benefit from drug-eluting stents compared with bare metal stents.
Researchers examined data that was submitted to the Massachusetts Data Analysis Center (Mass-DAC) at Harvard Medical School about patients with diabetes who underwent percutaneous coronary intervention between April 2003 and September 2004 (n=5,051). Patients had received either a drug-eluting stent (n=3,341) or bare metal stent (n=1,710). The primary endpoint was matched risk differences for death from any cause within three years of the PCI procedure.
After three years follow-up, the unadjusted mortality rate was lower among patients receiving drug-eluting stents vs base metal stents (14.4% vs 22.2%).
The investigators also matched subsets of patients receiving either drug-eluting stents or bare metal stents. Patients with diabetes who were treated with drug-eluting stents had a lower risk for mortality (risk difference: –3.2%; 95% CI, –6.0 to –0.4), a lower rate of subsequent MI (–3.3%; 95% CI, –5.6 to –0.5) and a lower rate of target vessel revascularization at three years (–5.4%; 95% CI, –8.3 to –2.4) vs. patients with diabetes who were treated with bare metal stents.
“This population-based analysis showed preserved efficacy of drug-eluting stents and no increased hazard of death and MI compared with bare metal stents in long-term follow-up,” said Laura Mauri, MD, an interventional cardiologist at Brigham and Women’s Hospital in Boston, said in a late-breaking trial presentation.
According to discussant David O. Williams, MD, director of interventional cardiology at Rhode Island Hospital in Providence, R.I., the results were encouraging and merited further study.
“The current data indicate that for patients with diabetes, drug-eluting stents provide significant benefit over bare metal stents for increasing the durability of the initial PCI,” Williams said. “Some investigations, including this one, suggest that rates of death and MI might actually be less with drug-eluting stents. These findings, however, require further validation.”
For more information:
- Garg P, Normand S, Silbaugh T, et al. Drug-eluting stent or bare metal stenting in patients with diabetes mellitus: Results from the Massachusetts Data Analysis Center Registry. Circulation. 2008;doi:10.1161/CIRCULATIONAHA.108.820159.