Paclitaxel-Eluting versus Everolimus-Eluting Coronary Stents in Diabetes

In this trial, 1830 patients undergoing PCI were assigned to receive a paclitaxel-eluting or an everolimus-eluting stent. At 1 year, rates of target-vessel failure, MI, stent thrombosis, and target-lesion and target-vessel revascularization were higher with paclitaxel. Diabetes mellitus is a highly prevalent medical condition globally and is frequently associated with symptomatic coronary artery disease necessitating percutaneous coronary intervention (PCI). 1 There is, however, controversy regarding the choice of a drug-eluting stent in patients with diabetes. Fundamental to this debate is the finding that there is attenuation of the mammalian target of rapamycin (mTOR) signaling pathway in patients with type 2 diabetes, which suggests that stents eluting rapamycin (now called sirolimus) or its analogues (everolimus or zotarolimus) — often termed “limus-eluting” stents — could be less effective in this cohort, potentially making paclitaxel-eluting stents an attractive option. 2 It . . .