Comparison of Outcomes Using Sirolimus-Eluting Stenting in Diabetic Versus Nondiabetic Patients With Comparison of Insulin Versus Non–Insulin Therapy in the Diabetic Patients

Kumar, Ramon; Lee, Tobias T.; Jeremias, Allen; Ruisi, Christopher P.; Sylvia, Brett; Magallon, Jorge; Kirtane, Ajay J.; Bigelow, Brian; Abrahamson, Martin J.; Pinto, Duane S.; Ho, Kalon K.L.; Cohen, David J.; Carrozza, Joseph P.; Cutlip, Donald E.

doi:10.1016/j.amjcard.2007.05.038

Cited by 41 publications

(21 citation statements)

References 19 publications

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“…There are potential reasons for the relatively lower event rate for diabetic patients in this study. First, we excluded diabetic patients receiving insulin therapy who have higher risk of in-stent restenosis and cardiovascular events than do diabetic patients who were treated with oral agents because of difficulties in measuring and interpreting insulin resistance (28). Second, diabetic patients with multivessel coronary disease or complex lesion characteristics are subject to referral for bypass surgery, and therefore, diabetic patients in this study had lower risk than those in other studies.…”

Section: Interaction Between Insulin Resistance and Other Risk Factorsmentioning

confidence: 92%

Impact of Insulin Resistance on Post-Procedural Myocardial Injury and Clinical Outcomes in Patients Who Underwent Elective Coronary Interventions With Drug-Eluting Stents

Uetani

Amano

Harada

et al. 2012

JACC: Cardiovascular Interventions

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Section: Interaction Between Insulin Resistance and Other Risk Factorsmentioning

confidence: 92%

Impact of Insulin Resistance on Post-Procedural Myocardial Injury and Clinical Outcomes in Patients Who Underwent Elective Coronary Interventions With Drug-Eluting Stents

Uetani

Amano

Harada

et al. 2012

JACC: Cardiovascular Interventions

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“…9) Prothrombotic and proinflammatory states, in adjunct to endothelial dysfunction and metabolic disorders, such as hyperglycemia, dyslipidemia, obesity, insulin resistance, and oxidative stress, are key features of the accelerated atherosclerotic progression observed in patients with diabetes. 17,18) Diabetes was associated with an increased risk of unfavorable clinical outcomes in both DES 19,20) and CABG populations. 21,22) Therefore, diabetes was an important consideration when deciding upon the optimal revascularization strategy for patients, especially those with complex lesions.…”

Section: Discussionmentioning

confidence: 99%

Influence of Diabetes Mellitus on Long-Term Outcomes of Patients With Unprotected Left Main Coronary Artery Disease Treated With Either Drug-Eluting Stents or Coronary Artery Bypass Grafting

Luo

et al. 2015

Int. Heart J.

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SummaryWhether the effect of diabetes on patients with unprotected left main coronary artery (ULMCA) disease differs according to different strategies of revascularization was unknown. This study was conducted to evaluate the impact of diabetes on patients with ULMCA disease treated with either percutaneous coronary intervention (PCI) or coronary-artery bypass grafting (CABG).A total of 922 patients with ULMCA disease who received drug-eluting stent (DES) (n = 465) implantation or underwent CABG (n = 457) were retrospectively analyzed. We compared the effects of these 2 treatments on clinical outcomes (death, myocardial infarction, stroke, repeat revascularization, and the composite of death, myocardial infarction, or stroke), according to diabetic status.During the median follow-up of 7.1 years (interquartile range, 5.3 to 8.2 years), no difference was found between PCI and CABG in the adjusted occurrence of death (P = 0.112) and the composite endpoints of death, myocardial infarction, and stroke (P = 0.235). Significantly higher incidence of repeat revascularization (P < 0.001) was observed in the DES group, whereas the CABG group had a significantly higher rate of stroke (P = 0.001). These trends were consistent in both diabetic and nondiabetic patients. We did not observe significant interactions between treatment outcomes and the presence or absence of diabetes after adjustment for covariates (P interaction = 0.580 for the composite of death, MI and stroke, P interaction = 0.685 for death, P interaction = 0.416 for MI, P interaction = 0.470 for stroke, and P interaction = 0.502 for repeat revascularization).Presence of diabetes was not important for decision-making between CABG and PCI in patients with ULMCA disease. (Int Heart J 2015; 56: 43-48)

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“…Although drug-eluting stent (DES) implantation significantly reduced the neointimal hyperplasia and angiographic restenosis compared with BMS in diabetic patients (3), presence of diabetes mellitus (DM) has been still associated with an increased risk of restenosis and unfavorable clinical outcomes in the era of DES (4,5). Recently, the relative efficacies of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in patients with DM have been evaluated in randomized and registry studies (6 -10).…”

mentioning

confidence: 99%

A Randomized Comparison of Sirolimus- Versus Paclitaxel-Eluting Stent Implantation in Patients With Diabetes Mellitus

Lee

Park

Kim

et al. 2008

Journal of the American College of Cardiology

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Comparison of Outcomes Using Sirolimus-Eluting Stenting in Diabetic Versus Nondiabetic Patients With Comparison of Insulin Versus Non–Insulin Therapy in the Diabetic Patients

Cited by 41 publications

References 19 publications

Impact of Insulin Resistance on Post-Procedural Myocardial Injury and Clinical Outcomes in Patients Who Underwent Elective Coronary Interventions With Drug-Eluting Stents

Impact of Insulin Resistance on Post-Procedural Myocardial Injury and Clinical Outcomes in Patients Who Underwent Elective Coronary Interventions With Drug-Eluting Stents

Influence of Diabetes Mellitus on Long-Term Outcomes of Patients With Unprotected Left Main Coronary Artery Disease Treated With Either Drug-Eluting Stents or Coronary Artery Bypass Grafting

A Randomized Comparison of Sirolimus- Versus Paclitaxel-Eluting Stent Implantation in Patients With Diabetes Mellitus

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