Sirolimus Stents May Reduce Restenosis in Diabetics with Coronary Disease
January 8, 2008 - Compared with paclitaxel-eluting stents (PES), sirolimus-eluting stents (SES) appear to decrease the risk of in-stent late luminal loss in diabetics with coronary artery disease, new research shows.
The optimal drug-eluting stents for diabetic patients has been unclear, lead author Fabrizio Tomai, M.D., from the European Hospital in Rome, and colleagues note in the January issue of Diabetes Care.
Comparing PES with SES has been difficult since there are so many individual variables that contribute to neointimal hyperplasia. In the present study, the researchers addressed this problem by comparing PES and SES directly in the same diabetic patient.
The study enrolled 60 patients with two or more significant de novo angiographic stenoses in different coronary segments. Overall, 60 lesions were successfully treated with PES and 60 with SES, the report shows. (Another 26 coronary lesions were treated with bare metal stents and were not included in the analysis.)
The main outcome measure was the occurrence of angiographic in-stent late luminal loss at eight-month follow-up. This was lower with the SES (0.26 mm) than with the PES (0.50 mm), a significant difference (p = 0.01).
On multivariate analysis, the type of drug-eluting stent was the only independent predictor of in-stent late luminal loss. Specifically, in-stent late luminal loss was 2.3-times more likely when a PES rather than a SES was used (p = 0.03).
Further research is needed to determine if the better angiographic results achieved with SES actually translate into long-term clinical benefits, the authors conclude.
For more information: care.diabetesjournals.org
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