|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 2002; 40:410-417 © 2002 by the American College of Cardiology Foundation |
,*
* Centre Hospitalier Régional, Lille, France
University of Lille, Lille, France
Manuscript received October 10, 2001; revised manuscript received March 27, 2002, accepted April 30, 2002.
* Reprint requests and correspondence: Dr. Eric Van Belle, Hôpital Cardiologique, Centre Hospitalier Régional, Boulevard du Professeur J. Leclercq, 59037 Lille Cedex, France.
ericvanbelle{at}aol.com
OBJECTIVES: We sought to compare coronary stent implantation with balloon angioplasty (BA), in a diabetic population, in terms of the six-month angiographic outcome and four-year clinical events.
BACKGROUND: Diabetic patients have a poor angiographic and clinical outcome after standard coronary BA. To date, it is still unclear whether stent implantation may improve this outcome.
METHODS: We investigated this issue by individual matching of 314 diabetic patients treated with either coronary stenting or standard BA. These two groups were derived from a population of consecutive diabetic patients (1993 to 1996). Matching criteria were gender, anti-diabetic regimen, stenosis location, reference diameter, and minimal luminal diameter (±0.4 mm). One lesion per patient was considered for matching.
RESULTS: Baseline characteristics were similar between the two groups of 157 patients. At six months, the rates of restenosis (27% vs. 62%; p < 0.0001) and occlusion (4% vs. 13%; p < 0.005) were lower in the stent group than in the BA group. This was associated with a significant decrease in ejection fraction at six months in the BA group (p = 0.02) while, during the same period, no change was observed in the stent group (p = NS). Subgroup analysis demonstrated that angiographic benefit was consistent among the subgroups. At four years, the combined clinical end point of cardiac death and non-fatal myocardial infarction was lower in the stent group (14.8% vs. 26.0%; p = 0.02), as was the need for repeat revascularization (35.4% vs. 52.1%; p = 0.001).
CONCLUSIONS: In a population of diabetic patients, coronary stent implantation was associated with a highly beneficial effect on the six-month angiographic outcome and four-year clinical events compared with standard BA.
| ||||||||||||||||||||||||
This article has been cited by other articles:
|
|
 |
|
  M. Billinger, J. Beutler, K. R. Taghetchian, A. Remondino, P. Wenaweser, S. Cook, M. Togni, C. Seiler, C. Stettler, F. R. Eberli, et al. Two-year clinical outcome after implantation of sirolimus-eluting and paclitaxel-eluting stents in diabetic patients Eur. Heart J., March 2, 2008; 29(6): 718 - 725. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Jimenez-Quevedo, M. Sabate, D. J. Angiolillo, F. Alfonso, R. Hernandez-Antolin, M. SanMartin, J. A. Gomez-Hospital, C. Banuelos, J. Escaned, R. Moreno, et al. Long-term clinical benefit of sirolimus-eluting stent implantation in diabetic patients with de novo coronary stenoses: long-term results of the DIABETES trial Eur. Heart J., August 2, 2007; 28(16): 1946 - 1952. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F Boccara, E Teiger, and A Cohen Role of drug eluting stents in diabetic patients Heart, May 1, 2006; 92(5): 579 - 581. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Susen, K. Sautiere, F. Mouquet, F. Cuilleret, A. Chmait, E. P. McFadden, B. Hennache, F. Richard, P. de Groote, J.-M. Lablanche, et al. Serum hepatocyte growth factor levels predict long-term clinical outcome after percutaneous coronary revascularization Eur. Heart J., November 2, 2005; 26(22): 2387 - 2395. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Franklin, R. J. Goldberg, F. Spencer, W. Klein, A. Budaj, D. Brieger, M. Marre, P. G. Steg, N. Gowda, J. M. Gore, et al. Implications of Diabetes in Patients With Acute Coronary Syndromes: The Global Registry of Acute Coronary Events Arch Intern Med, July 12, 2004; 164(13): 1457 - 1463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R Timmer, J. P. Ottervanger, K. Thomas, J. C.A Hoorntje, M.-J. de Boer, H. Suryapranata, F. Zijlstra, and on behalf of the Zwolle myocardial infarction stud Long-term, cause-specific mortality after myocardial infarction in diabetes Eur. Heart J., June 1, 2004; 25(11): 926 - 931. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. W. Vetrovec Don't blame the stents J. Am. Coll. Cardiol., April 21, 2004; 43(8): 1355 - 1357. [Full Text] [PDF]
|
|
|
|
 |
|
 N. E.J. West, P. N. Ruygrok, C. M.C. Disco, M. W.I. Webster, W. K. Lindeboom, W. W. O'Neill, N. F. Mercado, and P. W. Serruys Clinical and Angiographic Predictors of Restenosis After Stent Deployment in Diabetic Patients Circulation, February 24, 2004; 109(7): 867 - 873. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Mathew, B. J. Gersh, B. A. Williams, W. K. Laskey, J. T. Willerson, R. T. Tilbury, B. R. Davis, and D. R. Holmes Jr Outcomes in Patients With Diabetes Mellitus Undergoing Percutaneous Coronary Intervention in the Current Era: A Report From the Prevention of REStenosis with Tranilast and its Outcomes (PRESTO) Trial Circulation, February 3, 2004; 109(4): 476 - 480. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Abizaid, M. A. Costa, D. Blanchard, M. Albertal, H. Eltchaninoff, G. Guagliumi, L. Geert-Jan, A. S. Abizaid, A. G.M.R. Sousa, E. Wuelfert, et al. Sirolimus-eluting stents inhibit neointimal hyperplasia in diabetic patients: Insights from the RAVEL Trial Eur. Heart J., January 2, 2004; 25(2): 107 - 112. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. V. Desouza, S. N. Murthy, J. Diez, B. Dunne, A. S. Matta, V. A. Fonseca, and D. B. McNamara Differential Effects of Peroxisome Proliferator Activator Receptor-{alpha} and {gamma} Ligands on Intimal Hyperplasia After Balloon Catheter-Induced Vascular Injury in Zucker Rats Journal of Cardiovascular Pharmacology and Therapeutics, December 1, 2003; 8(4): 297 - 305. [Abstract] [PDF]
|
|
|
|
 |
|
 K. Stephenson, J. Tunstead, A. Tsai, R. Gordon, S. Henderson, and H. M. Dansky Neointimal Formation After Endovascular Arterial Injury Is Markedly Attenuated in db/db Mice Arterioscler. Thromb. Vasc. Biol., November 1, 2003; 23(11): 2027 - 2033. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K.-H. Mak and D. P. Faxon Clinical studies on coronary revascularization in patients with type 2 diabetes Eur. Heart J., June 2, 2003; 24(12): 1087 - 1103. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. Sousa, P. W. Serruys, and M. A. Costa New Frontiers in Cardiology: Drug-Eluting Stents: Part II Circulation, May 13, 2003; 107(18): 2383 - 2389. [Full Text] [PDF]
|
|
|
|
|
|
V. Mathew and D. R. Holmes Outcomes in diabetics undergoing revascularization: The long and the short of it J. Am. Coll. Cardiol., August 7, 2002; 40(3): 424 - 427. [Full Text] [PDF]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
