Clinical impact of second-generation everolimus-eluting stents compared with first-generation drug-eluting stents in diabetic patients undergoing multivessel percutaneous coronary intervention

Lakshmana Pendyala, Joshua Loh, Hironori Kitabata, Sa'ar Minha, Fang Chen, Rebecca Torguson, William Suddath, Lowell Satler, Augusto Pichard, Ron Waksman

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES: This study aimed to evaluate the safety and efficacy of everolimus-eluting stent (EES) use compared with first-generation drug-eluting stent (DES) use in diabetic patients undergoing multivessel percutaneous coronary intervention (PCI). BACKGROUND: Although the benefits of EES over first-generation DES were demonstrated for the general population, there is a paucity of data in diabetic patients with multivessel disease. METHODS: The retrospective study cohort included 429 consecutive diabetic patients who underwent native multivessel PCI, defined as ≥2 same-generation DESs in ≥2 different native vessel territories during the index procedure. The primary safety endpoint was the combined incidence of death, non-fatal Q-wave myocardial infarction, and definite stent thrombosis (ST) at 1 year. RESULTS: At 1 year, the primary safety endpoint was reached in 2.9% of the patients in the EES group, which was significantly lower than the 9.3% noted with first-generation DES (P≤.03). The occurrence of definite or probable ST was lower in the EES group (0% vs 3.7%; P≤.04). Similarly, there was a trend toward lower all-cause mortality (2.9% vs 8.5%; P≤.05) and cardiac death (1% vs 4.9%; P≤.08) in the EES group. However, there were no significant differences in the rates of target lesion revascularization (12.6% vs 9.3%; P≤.33) between groups. In a multivariate model, EES was independently associated with a lower risk of composite primary endpoint compared with first-generation DES (hazard ratio, 0.28; 95% confidence interval, 0.09-0.94). CONCLUSION: In diabetic patients undergoing native multivessel PCI, the use of EES was associated with superior 1-year safety as compared with use of first-generation DES.

Original languageEnglish
Pages (from-to)263-268
Number of pages6
JournalJournal of Invasive Cardiology
Volume27
Issue number6
StatePublished - 1 Jun 2015
Externally publishedYes

Keywords

  • diabetes mellitus
  • drug-eluting stents
  • multivessel PCI

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