Sirolimus-eluting stent implantation in diabetic patients with multivessel coronary artery disease

Carlo Briguori, Antonio Colombo, Flavio Airoldi, Amelia Focaccio, Ioannis Iakovou, Alaide Chieffo, Iassen Michev, Matteo Montorfano, Erminio Bonizzoni, Bruno Ricciardelli, Gerolama Condorelli

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Restenosis rate is lower after sirolimus-eluting stent (SES) implantation than after bare metal stent (BS) implantation. We evaluated the impact of SES implantation on immediate and 12-month outcome in diabetic patients with multivessel coronary artery disease (MVD). Methods: From April 2002 to September 2003, 100 consecutive diabetic patients with MVD without previous myocardial revascularization underwent successful elective percutaneous coronary intervention (PCI) with SES on native coronary arteries at our institutions. A group (n = 122) of consecutive diabetic patients with MVD treated with BS implantation (BS group) for de novo lesions was selected from our database and matched with the SES group. Major adverse cardiac events (MACEs) during hospital stay and at follow-up included nonfatal myocardial infarction, death, bypass surgery, and re-PCI. Results: At 12 ± 4 months, MACEs occurred in 25% of patients in the SES group and in 44% of those in the BS group (P = .003, OR .72, 95% CI 0.57-0.91). Need for repeat intervention (re-PCI or bypass surgery) occurred in 17% of patients in the SES group and in 41% of those in the BS group (P <.001, OR .67, 95% CI 0.52-0.86). No significant difference in the rate of death and myocardial infarction was observed. In the SES group, the independent predictors of MACEs at follow-up were premature clopidogrel discontinuation (hazard ratio 20.62, 95% CI 1.60-264.97, P = .020) and chronic renal insufficiency (hazard ratio 4.73, 95% CI 1.99-11.25, P = .0004). Conclusions: As compared with BS implantation, SES implantation favorably influences outcome in diabetic patients with MVD, mainly by reducing the need for new revascularization.

Original languageEnglish
Pages (from-to)807-813
Number of pages7
JournalAmerican Heart Journal
Volume150
Issue number4
DOIs
Publication statusPublished - Oct 2005

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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