Percutaneous coronary intervention in diabetics safe regardless of stent type

Stent type does not influence safety in diabetic patients undergoing percutaneous coronary intervention, a new study has found. Ultrathin bioresorbable-polymer sirolimus-eluting stent (BP-SES) and thin-strut durable-polymer everolimus-eluting stent (DP-EES) produce comparable 12-month target lesion failure (TLF) rates.

The study included 757 diabetic patients, of whom 494 received BP-SES (mean age, 64.9±9.1 years; 71.3 percent male) and 263 had DP-EES (mean age, 64.5±9.5 years; 74.5 percent male). The primary endpoint of the pooled analysis was TLF, defined as the composite of cardiovascular death, ischaemia-driven target lesion revascularization, stent thrombosis and target vessel myocardial infarction.

Thirty-one patients in the BP-SES group developed TLF after 1 year, resulting in an overall incidence rate of 6.3 percent. In comparison, the outcome was reported in 23 participants of the DP-EES group, yielding a corresponding rate of 8.7 percent. The difference failed to reach statistical significance (p=0.236).

Similarly, the rates of definite or probable stent thrombosis were comparable between the BP-SES and DP-EES groups (0.8 percent vs 1.1 percent; p=0.699). Disaggregation according to insulin treatment did not change the principal findings.

Cox regression analysis further verified these findings. The risk of TLF was comparable between the BP-SES and DP-EES groups (hazard ratio [HR], 0.82, 95 percent CI, 0.047–1.43; p=0.493) and between those who were and were not being treated with insulin (HR, 1.47, 0.84–2.57; p=0.182).