Clinical Efficacy of Drug-Eluting Stents in Diabetic PatientsA Meta-Analysis
Ehtisham Mahmud, MD, FACC*,
Guilherme Bromberg-Marin, MD,
Vachaspathi Palakodeti, MD, FACC,
Lawrence Ang, BS,
Dana Creanga, PhD and
Anthony N. DeMaria, MD, MACC
Division of Cardiovascular Medicine, University of California–San Diego Medical Center, San Diego, California.
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Figure 1 Clinical Event Rates for Diabetic Patients Treated With DES in RCTs
Point estimates for target lesion revascularization and major adverse cardiac events for diabetic patients treated with drug-eluting stents (DES) in (A) all randomized controlled trials (RCTs) and (B) RCTs with Silber score >5. Bars indicate 95% confidence intervals.
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Figure 2 Comparative Analysis of Target Lesion Revascularization With Drug-Eluting Stents in Diabetic Patients From Head-to-Head Randomized Controlled Trials
Likelihood of target lesion revascularization (paclitaxel-eluting stent [PES] vs. sirolimus-eluting stent [SES]) (n = 899 diabetic patients). Size of boxes indicates relative contribution of each trial. See Table 1 for further details regarding the individual trials included. CI = confidence interval; ISAR-DIABETES = Intracoronary Stenting and Angiographic Results: Do Diabetic Patients Derive Similar Benefit from Paclitaxel-Eluting and Sirolimus-Eluting Stents trial; pc = personal communication from J. J. Goy, 2006; REALITY = Sirolimus- vs Paclitaxel-Eluting Stents in De Novo Coronary Artery Lesions trial; SIRTAX = Sirolimus-eluting and Paclitaxel-eluting Stents for Coronary Revascularization trial; TAXi = A Prospective Randomized Comparison Between Paclitaxel and Sirolimus Eluting Stents in the Real World of Interventional Cardiology trial.
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Figure 3 Clinical Event Rates for Diabetic Patients Treated With Drug-Eluting Stents in Registries
Point estimates for target vessel revascularization and major adverse cardiac events for diabetic patients treated with drug-eluting stents in all registries. Bars indicate 95% confidence intervals.
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Figure 4 Comparative Analysis of Clinical Events for Diabetic Patients Treated With Drug-Eluting Stents in Registries Enrolling Similar Populations
(A) Likelihood of target vessel revascularization (PES vs. SES) (n = 5,542 diabetic patients). (B) Likelihood of major adverse cardiac events (PES vs. SES) (n = 5,006 diabetic patients). Size of boxes indicates relative contribution of each study. See Table 2 for further details regarding registries included. C REWARDS = Cypher Registry Experience at the Washington Hospital Center With Drug-Eluting Stents; RESEARCH/T-SEARCH = Rapamycin-Eluting and Taxus Stent Evaluated At Rotterdam Cardiology Hospital registries; SOLACI = Society of Latin American Interventional Cardiologists registry; STENT = Strategic Transcatheter Evaluation of New Therapies group; T REWARDS = Taxus Registry Experience at the Washington Hospital Center With Drug-Eluting Stents; TC-WYRE = The Taxus Cypher "What's Your Real-World Experience" study; other abbreviations as in Figure 2.
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