Outcomes of diabetics receiving bare-metal stents versus drug-eluting stents
Vijay S. Ramanath MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorJeremiah R. Brown PhD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, New Hampshire
Search for more papers by this authorDavid J. Malenka MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorJames T. DeVries MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorMandeep S. Sidhu MD, MBA
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorJohn F. Robb MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorJohn E. Jayne MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorBruce D. Hettleman MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorBruce J. Friedman MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorNathaniel W. Niles II MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorAaron V. Kaplan MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorCorresponding Author
Craig A. Thompson MD, MMSc
Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut
Associate Professor of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, 333 Ceder Street, PO Box 208017, New Haven, CT 06520-8017Search for more papers by this authorVijay S. Ramanath MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorJeremiah R. Brown PhD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, New Hampshire
Search for more papers by this authorDavid J. Malenka MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorJames T. DeVries MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorMandeep S. Sidhu MD, MBA
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorJohn F. Robb MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorJohn E. Jayne MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorBruce D. Hettleman MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorBruce J. Friedman MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorNathaniel W. Niles II MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorAaron V. Kaplan MD
Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Dartmouth Medical School, Lebanon, New Hampshire
Search for more papers by this authorCorresponding Author
Craig A. Thompson MD, MMSc
Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, Connecticut
Associate Professor of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, 333 Ceder Street, PO Box 208017, New Haven, CT 06520-8017Search for more papers by this authorAbstract
Objectives: We sought to determine if differences existed in in-hospital outcomes, long-term rates of target vessel revascularization (TVR), and/or long-term mortality trends between patients with diabetes mellitus undergoing percutaneous coronary intervention (PCI) with either a drug-eluting stent(s) (DES) or a bare metal stent(s) (BMS). Background: Short- and long-term clinical outcomes of patients with diabetes mellitus undergoing PCI with DES versus BMS remain inconsistent between randomized-controlled trials (RCTs) and observational studies. Methods: Data were collected prospectively on diabetics undergoing PCI with either DES or BMS from January 2000 to June 2008. Demographic information, medical histories, in-hospital outcomes, and long-term TVR and mortality trends were obtained for all patients. Results: A total of 1,319 patients were included in the study. Diabetics receiving DES had a significant reduction in index admission MACE compared to diabetics receiving BMS. Using multivariable adjustment, after a mean follow-up of 2.5 years (maximum 5 years), diabetics who received DES had a 38% decreased risk of TVR compared to diabetics with BMS [HR 0.62 (95% CI: 0.43–0.90)]; diabetics with DES had an insignificant adjusted improvement in long-term survival compared to diabetics with BMS [HR 0.72 (95% CI: 0.52–1.00)]. These long-term survival and TVR rates were confirmed using propensity scoring. Conclusions: The use of DES when compared with BMS among diabetics undergoing PCI is associated with significant improvement in long-term TVR, with an insignificant similar trend in all-cause mortality. The long-term results of this observational study are consistent with prior RCTs after adjusting for confounding variables. © 2010 Wiley-Liss, Inc.
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