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Stent type may influence thrombosis rates in patients with diabetes
Everolimus-eluting stents are associated with lower rates of stent thrombosis compared with paclitaxel-eluting stents in those with diabetes, but after adjustment, the composite rate of target lesion revascularization major adverse events was similar between stent types at 1 year, study results have concluded.
Researchers enrolled 968 consecutive patients with diabetes who underwent PCI with everolimus-eluting stents (EES; n=388) or paclitaxel-eluting stents (PES; n=580) at a single institution from March 2004 to May 2010.
Patients receiving the PES were more likely to have a family history of CAD, insulin-dependent diabetes, a higher number of lesions treated, longer stents used, and a higher proportion of IVUS and glycoprotein IIb/IIIa inhibitors. The EES group had more unstable angina at initial diagnosis, and more type C and distal lesions.
At 30 days, the PES group was more likely to have TLR-MACE (4.2% vs. 1.3%; P=.02), as well as a higher rate of stent thrombosis (eight patients vs. 0 in the EES group; P=.03) at 30 days. Stent thrombosis was higher in the PES group at 6 and 12 months, and mortality was higher at 12 months (9.4% vs. 5.2%; P=.02). There were no significant differences between stent types for HRs at 1-year follow-up of TLR-MACE.
“The totality of the evidence does not support superiority of PES or EES or vice versa; therefore, when selecting a [drug-eluting stent] for patient with diabetes, other considerations should be taken into account,” the researcher wrote. “At this stage, the decision should be left to operator discretion.”
Disclosure: The researchers report no relevant financial disclosures.