Long-term clinical benefit of drug-eluting stents over bare-metal stents in diabetic patients with de novo left main coronary artery disease: Results from a real-world multicenter registry

Davide Capodanno, Maria Elena Di Salvo, Tullio Palmerini, Imad Sheiban, Massimo Margheri, Giuseppe Vecchi, Giuseppe Sangiorgi, Giancarlo Piovaccari, Antonio Bartorelli, Carlo Briguori, Diego Ardissino, Francesco Di Pede, Angelo Ramondo, Luigi Inglese, Anna Sonia Petronio, Leonardo Bolognese, Alberto Benassi, Cataldo Palmieri, Vincenzo Filippone, Stefano De ServiCorrado Tamburino

Research output: Contribution to journalArticle

Abstract

Background: Few data are available on diabetic patients undergoing percutaneous coronary intervention (PCI) in the context of unprotected left main coronary artery (ULMCA) disease. The main goal of this study was to present the long-term relative benefits of using drug-eluting stent (DES) instead of bare-metal stent (BMS) for diabetic patients submitted to percutaneous ULMCA treatment in a large real world multicenter registry. Methods: The GISE-SICI registry is a retrospective, observational multicenter registry promoted by the Italian Society of Invasive Cardiology in which 19 high-volume participating centers enrolled 1,453 consecutive patients who underwent PCI on ULMCA between January 2002 and December 2006. From the registry, a total of 398 consecutive patients with diabetes mellitus who underwent DES (n=321) or BMS (n=77) implantation were analyzed, with extensive multivariable adjustments. Results: At 3-years, use of DES in diabetic patients resulted in no significant differences with respect to death (HR 0.56, 95% CIs 0.24-1.28), myocardial infarction (HR 0.82, 95% CIs 0.21-3.26), and the composite end-point of death or myocardial infarction (HR 0.56, 95% CIs 0.27-1.20). Conversely, DES were associated with significant reduction of target lesion revascularization (TLR, HR 0.33; 95% CIs 0.14-0.80, P=0.001) rates. Conclusions: Patients presenting with ULMCA disease in the context of diabetes mellitus who are treated with stent-supported PCI have a significant reduction in the rate of TLR with no increased risk of death or myocardial infarction.

Original languageEnglish
Pages (from-to)310-316
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume73
Issue number3
DOIs
Publication statusPublished - Feb 15 2009

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Keywords

  • Diabetes mellitus
  • Drug eluting stent
  • Unprotected left main

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Capodanno, D., Di Salvo, M. E., Palmerini, T., Sheiban, I., Margheri, M., Vecchi, G., Sangiorgi, G., Piovaccari, G., Bartorelli, A., Briguori, C., Ardissino, D., Di Pede, F., Ramondo, A., Inglese, L., Petronio, A. S., Bolognese, L., Benassi, A., Palmieri, C., Filippone, V., ... Tamburino, C. (2009). Long-term clinical benefit of drug-eluting stents over bare-metal stents in diabetic patients with de novo left main coronary artery disease: Results from a real-world multicenter registry. Catheterization and Cardiovascular Interventions, 73(3), 310-316. https://doi.org/10.1002/ccd.21845