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Coron Artery Dis. 2013 Dec;24(8):676-83. doi: 10.1097/MCA.0b013e3283650210.

Comparison of clinical outcomes between first-generation and second-generation drug-eluting stents in type 2 diabetic patients.

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  • 1aDepartment of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul bDepartment of Cardiology, Sejong General Hospital, Bucheon, Korea.

Abstract

BACKGROUND:

Drug-eluting stent (DES) implantation has significantly reduced the risk of restenosis and major adverse cardiac event (MACE) rates compared with bare-metal stents in type 2 diabetic patients. Differences in outcomes between the first-generation and second-generation DESs in diabetic patients, however, have yet to be evaluated.

AIM:

We compared MACEs after second-generation DES implantation compared with those of first-generation stents in diabetic patients.

METHODS AND RESULTS:

This single-center prospective cohort study compared first-generation DES (n=654) and second-generation DES (n=339) implantation in type 2 diabetic patients by propensity score matching. The primary outcome was the occurrence of MACEs, defined as a composite of all-cause death, nonfatal myocardial infarction, and target vessel revascularization. The rate of MACEs was lower in the second-generation DES group after 2 years of follow-up (3.3 vs. 10.0%, P<0.001). Kaplan-Meier analysis showed higher MACE-free survival in diabetic patients in the second-generation DES group (log-rank P<0.001). In a Cox regression analysis, first-generation DES (hazard ratio=3.60, 95% confidence interval, 2.03-6.37, P<0.001) was an independent predictor for MACEs.

CONCLUSION:

In type 2 diabetic patients, second-generation DES implantation resulted in lower MACEs compared with first-generation DESs, primarily because of lower target lesion and vessel revascularization rates.

PMID:
23994881
[PubMed - indexed for MEDLINE]
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