Article (Scientific journals)
One-year clinical outcomes after sirolimus-eluting coronary stent implantation in diabetics enrolled in the worldwide e-SELECT registry.
Bartorelli, Antonio L.; Egidy Assenza, Gabriele; Abizaid, Alexandre et al.
2015In Catheterization and Cardiovascular Interventions
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Keywords :
antithrombotic therapy; bleeding complications; diabetes mellitus; percutaneous coronary intervention; sirolimus-eluting stent; stent thrombosis
Abstract :
[en] BACKGROUND: Diabetes mellitus has worse outcome after percutaneous coronary intervention. AIM: We assessed stent thrombosis (ST), major adverse cardiac events (MACE), and major bleeding rates at 1 year after implantation of sirolimus-eluting stents (SES) in patients with diabetes mellitus in a large multicenter registry. METHODS: From May 2006 to April 2008, 15,147 unselected consecutive patients were enrolled at 320 centers in 56 countries in a prospective, observational registry after implantation of >/= 1 SES. Source data were verified in 20% randomly chosen patients at > 100 sites. Adverse events were adjudicated by an independent Clinical Event Committee. RESULTS: Complete follow-up at 1 year was obtained in 13,693 (92%) patients, 4,577 (30%) of whom were diabetics. Within diabetics, 1,238 (9%) were insulin-treated diabetics (ITD). Diabetics were older (64 vs. 62 years, P < 0.001), with higher incidence of major coronary risk factors, co-morbidities, and triple-vessel coronary artery disease. Coronary lesions had smaller reference vessel diameter (2.88 +/- 0.46 vs. 2.93 +/- 0.45 mm, P < 0.001) and were more often heavily calcified (26.1% vs. 22.6%, P < 0.001). At 1 year, diabetics had higher MACE rate (6.8% vs. 3.9%, P < 0.001) driven by ITD (10.6% vs. 5.5%, P < 0.001). Finally, diabetics had significant increase in ST (1.7% vs. 0.7%, P < 0.001), principally owing to ITD (3.4% vs. 1.1%, P < 0.001). There was an overall low risk of major bleeding during follow-up, without significant difference among subgroups. CONCLUSIONS: In the e-SELECT registry, diabetics represented 30% of patients undergoing SES implantation and had significantly more co-morbidities and complex coronary lesions. Although 1-year follow-up documented good overall outcome in diabetics, higher ST and MACE rates were observed, mainly driven by ITD. (c) 2015 Wiley Periodicals, Inc.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Bartorelli, Antonio L.
Egidy Assenza, Gabriele
Abizaid, Alexandre
Banning, Adrian
Dzavik, Vladimir
Ellis, Stephen
Gao, Runlin
Holmes, David
Ho Jeong, Myung
LEGRAND, Victor ;  Centre Hospitalier Universitaire de Liège - CHU > Cardiologie
Neumann, Franz-Josef
Spaulding, Christian
Worthley, Stephen G.
Urban, Philip
More authors (4 more) Less
Language :
English
Title :
One-year clinical outcomes after sirolimus-eluting coronary stent implantation in diabetics enrolled in the worldwide e-SELECT registry.
Publication date :
2015
Journal title :
Catheterization and Cardiovascular Interventions
ISSN :
1522-1946
eISSN :
1522-726X
Publisher :
John Wiley & Sons, Hoboken, United States - New York
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
(c) 2015 Wiley Periodicals, Inc.
Available on ORBi :
since 14 January 2016

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