The clinical and angiographic results of paclitaxel-eluting stents in patients with diabetes mellitus

OBJECTIVES
We evaluated the long-term results of paclitaxel-eluting stents in diabetic patients with symptomatic coronary artery disease (CAD).

STUDY DESIGN
A total of 200 patients with symptomatic CAD, a positive treadmill test, and angiographically confirmed lesions (≥2 mm and ≥70%) underwent paclitaxel-eluting stent implantation (n=267). The patients were assessed in two groups depending on the presence (n=68; 46 men, 22 women; mean age 58.7 years) or absence (n=132; 103 men, 29 women; mean age 56.5 years) of diabetes. Coronary angiographies were repeated after a mean of 12.1±5.1 months following implantation. The mean follow-up was 15.4±6.4 months. Major cardiac events included acute myocardial infarction (AMI), death, and a subsequent intervention.

RESULTS
The diabetic group presented with smaller pre-procedure reference vessel diameters, a greater number of bifurcations, long lesions, and long stents (p<0.05). Other quantitative measurements did not differ significantly. Mortality did not occur during the follow-up period. Major cardiac events did not differ significantly between patients with (5.9%) and without (3.8%) diabetes (p>0.05). The incidences of AMI (1.5% vs 0.8%), recurrent angina pectoris (2.9% vs 2.3%), percutaneous angioplasty (2.9% vs 2.3%), and surgical revascularization (1.5% vs 0.8%) were not different in the diabetic and nondiabetic groups, respectively (p>0.05). Major cardiac events were similar in diabetic patients receiving insulin or oral antidiabetic agents.

CONCLUSION
Our data favor the effective and safe use of paclitaxel-eluting stents in diabetic patients with respect to comparably low rates of restenosis and major cardiac events.