Paclitaxel and sirolimus stents result in similar 4-year outcomes in diabetics
MedWire News: Long-term results from the DES-DIABETES trial show no additional benefits of using sirolimus-eluting stents (SES) over paclitaxel-eluting stents (PES) for revascularization in patients with diabetes and cardiovascular disease (CVD).
Previous study findings suggested that SES implantation may result in a better outcome for diabetics with CVD than revascularization with PES, but follow-up times were short.
The Drug-Eluting Stent in patients with DIABETES mellitus (DES-DIABETES) trial investigators compared outcomes of patients given SES (n=200) with those given PES (n=200) over 4 years. The participants were aged 18 years or above, were diabetic, and had angina pectoris, a positive stress test, significant angiographic stenosis, or a combination of the three.
The study participants were followed-up for incidence of major cardiovascular events (MACE), which included death, myocardial infarction (MI), and target lesion revascularization (TLR).
At 2 years, Seong-Wook Park (University of Ulsan College of Medicine, Seoul, Korea) and colleagues recorded the incidence of MACE as 3.5% in the SES group and 11.0% in the PES group, a significant difference.
However, at 4 years, the between-group difference had decreased to a nonsignificant level, with MACE rates of 11.0% and 16.0% in the SES and PES groups, respectively.
Rates of death (3.0% vs 5.0%), MI (1.5% vs 1.0%), and TLR (7.5% vs 12.0%) were also nonsignificantly different between the SES and PES groups at 4 years.
The researchers note that a low post-procedural minimal lumen diameter, hypercholesterolemia, and use of intravascular ultrasound were all predictive of 4-year MACE.
"These findings give us the message that the two first-generation drug eluting stents have a similar efficacy during long-term follow-up in diabetic patients," conclude Park and team in the Journal of the American College of Cardiology: Cardiovascular Interventions.
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By Helen Albert