Differences in clinical and angiographic outcomes with different drug-eluting stents in Japanese patients with and without diabetes mellitus
Abstract Background Although percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM) is associated with worse clinical outcomes, the efficacy of drug-eluting stents (DES) in Japanese patients and differences in effectiveness between different DES types remain unknown. Method...
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Veröffentlicht in: | Journal of cardiology 2012-11, Vol.60 (5), p.361-366 |
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creator | Sato, Tetsuya, MD, PhD Ono, Tamaki, MD Morimoto, Yoshimasa, MD Kawai, Haruaki, MD Fuke, Soichiro, MD, PhD Ikeda, Tetsuya, MD, PhD Saito, Hironori, MD, PhD, FJCC |
description | Abstract Background Although percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM) is associated with worse clinical outcomes, the efficacy of drug-eluting stents (DES) in Japanese patients and differences in effectiveness between different DES types remain unknown. Methods and subjects Five-hundred and sixty-two consecutive patients (183 with DM, 379 without DM) with 676 lesions were treated with sirolimus-eluting stents (SES, n = 531; 160 DM group, 371 non-DM group) or paclitaxel-eluting stents (PES, n = 145; 64 and 81, respectively). We assessed the initial and 8-month follow-up clinical and angiographic outcomes. Results There were no significant differences in clinical and lesion characteristics, although the pre-minimum luminal diameter was smaller in the DM group ( p = 0.016). The risk of major adverse cardiac events (MACE), defined as cardiac death, non-fatal myocardial infarction, congestive heart failure, or recurrent angina pectoris, was higher in the DM group compared with the non-DM group (17.4% vs 9.5%, p = 0.007). Among diabetic patients, although SES reduced late loss by 0.45 mm ( p < 0.001) and the binary restenosis rate by 66.4% (7.4% vs 22.0%, p < 0.001) compared with PES at 8 months, it did not reduce target lesion revascularization or MACE, as in the non-DM group. Conclusions Diabetic patients have worse mid-term prognosis than non-diabetic patients undergoing PCI with DES. Although the superiority of SES in terms of late loss or restenosis may not play a clinically meaningful role in the treatment of diabetic patients, this phenomenon was independent of the presence of diabetes. |
doi_str_mv | 10.1016/j.jjcc.2012.07.002 |
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Methods and subjects Five-hundred and sixty-two consecutive patients (183 with DM, 379 without DM) with 676 lesions were treated with sirolimus-eluting stents (SES, n = 531; 160 DM group, 371 non-DM group) or paclitaxel-eluting stents (PES, n = 145; 64 and 81, respectively). We assessed the initial and 8-month follow-up clinical and angiographic outcomes. Results There were no significant differences in clinical and lesion characteristics, although the pre-minimum luminal diameter was smaller in the DM group ( p = 0.016). The risk of major adverse cardiac events (MACE), defined as cardiac death, non-fatal myocardial infarction, congestive heart failure, or recurrent angina pectoris, was higher in the DM group compared with the non-DM group (17.4% vs 9.5%, p = 0.007). Among diabetic patients, although SES reduced late loss by 0.45 mm ( p < 0.001) and the binary restenosis rate by 66.4% (7.4% vs 22.0%, p < 0.001) compared with PES at 8 months, it did not reduce target lesion revascularization or MACE, as in the non-DM group. Conclusions Diabetic patients have worse mid-term prognosis than non-diabetic patients undergoing PCI with DES. Although the superiority of SES in terms of late loss or restenosis may not play a clinically meaningful role in the treatment of diabetic patients, this phenomenon was independent of the presence of diabetes.</description><identifier>ISSN: 0914-5087</identifier><identifier>EISSN: 1876-4738</identifier><identifier>DOI: 10.1016/j.jjcc.2012.07.002</identifier><identifier>PMID: 22890073</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cardiovascular ; Coronary Angiography ; Coronary Disease - complications ; Coronary Disease - diagnostic imaging ; Coronary Disease - therapy ; Coronary Restenosis - etiology ; Coronary Restenosis - prevention & control ; Diabetes ; Diabetes Complications ; Drug-eluting stent ; Drug-Eluting Stents - adverse effects ; Female ; Follow-Up Studies ; Humans ; Major adverse cardiac events ; Male ; Middle Aged ; Paclitaxel ; Percutaneous Coronary Intervention - adverse effects ; Prognosis ; Retrospective Studies ; Sirolimus ; Treatment Outcome</subject><ispartof>Journal of cardiology, 2012-11, Vol.60 (5), p.361-366</ispartof><rights>Japanese College of Cardiology</rights><rights>2012 Japanese College of Cardiology</rights><rights>Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c479t-367b5d92916c9efaf0d3ce5b27f3284e69ea707100524d3fbd7d1020ae2be9b53</citedby><cites>FETCH-LOGICAL-c479t-367b5d92916c9efaf0d3ce5b27f3284e69ea707100524d3fbd7d1020ae2be9b53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0914508712001281$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22890073$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sato, Tetsuya, MD, PhD</creatorcontrib><creatorcontrib>Ono, Tamaki, MD</creatorcontrib><creatorcontrib>Morimoto, Yoshimasa, MD</creatorcontrib><creatorcontrib>Kawai, Haruaki, MD</creatorcontrib><creatorcontrib>Fuke, Soichiro, MD, PhD</creatorcontrib><creatorcontrib>Ikeda, Tetsuya, MD, PhD</creatorcontrib><creatorcontrib>Saito, Hironori, MD, PhD, FJCC</creatorcontrib><title>Differences in clinical and angiographic outcomes with different drug-eluting stents in Japanese patients with and without diabetes mellitus</title><title>Journal of cardiology</title><addtitle>J Cardiol</addtitle><description>Abstract Background Although percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM) is associated with worse clinical outcomes, the efficacy of drug-eluting stents (DES) in Japanese patients and differences in effectiveness between different DES types remain unknown. Methods and subjects Five-hundred and sixty-two consecutive patients (183 with DM, 379 without DM) with 676 lesions were treated with sirolimus-eluting stents (SES, n = 531; 160 DM group, 371 non-DM group) or paclitaxel-eluting stents (PES, n = 145; 64 and 81, respectively). We assessed the initial and 8-month follow-up clinical and angiographic outcomes. Results There were no significant differences in clinical and lesion characteristics, although the pre-minimum luminal diameter was smaller in the DM group ( p = 0.016). The risk of major adverse cardiac events (MACE), defined as cardiac death, non-fatal myocardial infarction, congestive heart failure, or recurrent angina pectoris, was higher in the DM group compared with the non-DM group (17.4% vs 9.5%, p = 0.007). Among diabetic patients, although SES reduced late loss by 0.45 mm ( p < 0.001) and the binary restenosis rate by 66.4% (7.4% vs 22.0%, p < 0.001) compared with PES at 8 months, it did not reduce target lesion revascularization or MACE, as in the non-DM group. Conclusions Diabetic patients have worse mid-term prognosis than non-diabetic patients undergoing PCI with DES. Although the superiority of SES in terms of late loss or restenosis may not play a clinically meaningful role in the treatment of diabetic patients, this phenomenon was independent of the presence of diabetes.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Asian Continental Ancestry Group</subject><subject>Cardiovascular</subject><subject>Coronary Angiography</subject><subject>Coronary Disease - complications</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>Coronary Disease - therapy</subject><subject>Coronary Restenosis - etiology</subject><subject>Coronary Restenosis - prevention & control</subject><subject>Diabetes</subject><subject>Diabetes Complications</subject><subject>Drug-eluting stent</subject><subject>Drug-Eluting Stents - adverse effects</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Major adverse cardiac events</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Paclitaxel</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Sirolimus</subject><subject>Treatment Outcome</subject><issn>0914-5087</issn><issn>1876-4738</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kstu1TAQhi1ERQ-FF2CBsmSTMONcnEgICZVbq0osgLXl2JNTh9ywHVDfgYfGOee0CxYsLFuj__80nn8Ye4GQIWD1us_6XuuMA_IMRAbAH7Ed1qJKC5HXj9kOGizSEmpxzp563wNU0NTVE3bOed0AiHzH_ry3XUeOJk0-sVOiBztZrYZETSaevZ33Ti23VifzGvQ8RtVvG24Tc7KFxLh1n9KwBjvtEx9i6QC6VouayFOyqGAPxYNvw26PSIsM1VKIxJGGwYbVP2NnnRo8PT_dF-z7xw_fLj-nN18-XV2-u0l1IZqQ5pVoS9PwBivdUKc6MLmmsuWiy3ldUNWQEiAQoOSFybvWCIPAQRFvqWnL_IK9OnIXN_9cyQc5Wq9jE7HjefUSsUQBiFxEKT9KtZu9d9TJxdlRuTuJILcUZC-3FOSWggQhYwrR9PLEX9uRzIPlfuxR8OYooPjLX5ac9NpuGRjrSAdpZvt__tt_7Pex_aA78v28uinOT6L00SO_bnuwrQFyiJQa87-ClrCu</recordid><startdate>20121101</startdate><enddate>20121101</enddate><creator>Sato, Tetsuya, MD, PhD</creator><creator>Ono, Tamaki, MD</creator><creator>Morimoto, Yoshimasa, MD</creator><creator>Kawai, Haruaki, MD</creator><creator>Fuke, Soichiro, MD, PhD</creator><creator>Ikeda, Tetsuya, MD, PhD</creator><creator>Saito, Hironori, MD, PhD, FJCC</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20121101</creationdate><title>Differences in clinical and angiographic outcomes with different drug-eluting stents in Japanese patients with and without diabetes mellitus</title><author>Sato, Tetsuya, MD, PhD ; Ono, Tamaki, MD ; Morimoto, Yoshimasa, MD ; Kawai, Haruaki, MD ; Fuke, Soichiro, MD, PhD ; Ikeda, Tetsuya, MD, PhD ; Saito, Hironori, MD, PhD, FJCC</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c479t-367b5d92916c9efaf0d3ce5b27f3284e69ea707100524d3fbd7d1020ae2be9b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Asian Continental Ancestry Group</topic><topic>Cardiovascular</topic><topic>Coronary Angiography</topic><topic>Coronary Disease - complications</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>Coronary Disease - therapy</topic><topic>Coronary Restenosis - etiology</topic><topic>Coronary Restenosis - prevention & control</topic><topic>Diabetes</topic><topic>Diabetes Complications</topic><topic>Drug-eluting stent</topic><topic>Drug-Eluting Stents - adverse effects</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Major adverse cardiac events</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Paclitaxel</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Sirolimus</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sato, Tetsuya, MD, PhD</creatorcontrib><creatorcontrib>Ono, Tamaki, MD</creatorcontrib><creatorcontrib>Morimoto, Yoshimasa, MD</creatorcontrib><creatorcontrib>Kawai, Haruaki, MD</creatorcontrib><creatorcontrib>Fuke, Soichiro, MD, PhD</creatorcontrib><creatorcontrib>Ikeda, Tetsuya, MD, PhD</creatorcontrib><creatorcontrib>Saito, Hironori, MD, PhD, FJCC</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sato, Tetsuya, MD, PhD</au><au>Ono, Tamaki, MD</au><au>Morimoto, Yoshimasa, MD</au><au>Kawai, Haruaki, MD</au><au>Fuke, Soichiro, MD, PhD</au><au>Ikeda, Tetsuya, MD, PhD</au><au>Saito, Hironori, MD, PhD, FJCC</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differences in clinical and angiographic outcomes with different drug-eluting stents in Japanese patients with and without diabetes mellitus</atitle><jtitle>Journal of cardiology</jtitle><addtitle>J Cardiol</addtitle><date>2012-11-01</date><risdate>2012</risdate><volume>60</volume><issue>5</issue><spage>361</spage><epage>366</epage><pages>361-366</pages><issn>0914-5087</issn><eissn>1876-4738</eissn><abstract>Abstract Background Although percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM) is associated with worse clinical outcomes, the efficacy of drug-eluting stents (DES) in Japanese patients and differences in effectiveness between different DES types remain unknown. Methods and subjects Five-hundred and sixty-two consecutive patients (183 with DM, 379 without DM) with 676 lesions were treated with sirolimus-eluting stents (SES, n = 531; 160 DM group, 371 non-DM group) or paclitaxel-eluting stents (PES, n = 145; 64 and 81, respectively). We assessed the initial and 8-month follow-up clinical and angiographic outcomes. Results There were no significant differences in clinical and lesion characteristics, although the pre-minimum luminal diameter was smaller in the DM group ( p = 0.016). The risk of major adverse cardiac events (MACE), defined as cardiac death, non-fatal myocardial infarction, congestive heart failure, or recurrent angina pectoris, was higher in the DM group compared with the non-DM group (17.4% vs 9.5%, p = 0.007). Among diabetic patients, although SES reduced late loss by 0.45 mm ( p < 0.001) and the binary restenosis rate by 66.4% (7.4% vs 22.0%, p < 0.001) compared with PES at 8 months, it did not reduce target lesion revascularization or MACE, as in the non-DM group. Conclusions Diabetic patients have worse mid-term prognosis than non-diabetic patients undergoing PCI with DES. Although the superiority of SES in terms of late loss or restenosis may not play a clinically meaningful role in the treatment of diabetic patients, this phenomenon was independent of the presence of diabetes.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>22890073</pmid><doi>10.1016/j.jjcc.2012.07.002</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Aged Aged, 80 and over Asian Continental Ancestry Group Cardiovascular Coronary Angiography Coronary Disease - complications Coronary Disease - diagnostic imaging Coronary Disease - therapy Coronary Restenosis - etiology Coronary Restenosis - prevention & control Diabetes Diabetes Complications Drug-eluting stent Drug-Eluting Stents - adverse effects Female Follow-Up Studies Humans Major adverse cardiac events Male Middle Aged Paclitaxel Percutaneous Coronary Intervention - adverse effects Prognosis Retrospective Studies Sirolimus Treatment Outcome |
title | Differences in clinical and angiographic outcomes with different drug-eluting stents in Japanese patients with and without diabetes mellitus |
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