Drug eluting stents in patients with diabetes

doi:10.1136/bmj.a1359

Published 31 August 2008, doi:10.1136/bmj.a1359
Cite this as: BMJ 2008;337:a1359

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Drug eluting stents in patients with diabetes

Long term aspirin and clopidogrel are key to improving safety

The first 150 words of the full text of this article appear below.

A quarter of people who need myocardial revascularisation havediabetes. After coronary artery bypass surgery and percutaneouscoronary interventions, these patients have worse outcomes thanthose without diabetes.¹ They have more extensive coronary atherosclerosis,accelerated plaque progression, an increased rate of restenosisafter percutaneous coronary intervention, and faster progressionof bypass graft disease after bypass surgery.² Randomised trialshave indicated that—especially in terms of repeated revascularisationprocedures—coronary artery bypass surgery is more effectivethan percutaneous coronary intervention with bare metal stentsin patients with diabetes, particularly in multivessel coronarydisease.¹ In the linked meta-analysis (doi: 10.1136/bmj.a1331),Stettler and colleagues compare the effectiveness and safetyof sirolimus eluting stents, paclitaxel eluting stents, andbare metal stents in people with and without diabetes.³

Because of local pharmacological inhibition of restenosis, drugeluting stents reduce the need for repeated revascularisationcompared with bare metal stents. It was hoped that these stentswould . . . [Full text of this article]

Pierfrancesco Agostoni, interventional cardiologist, Frank Van den Branden, departmental director

¹ Antwerp Cardiovascular Institute Middelheim, Ziekenhuis Netwerk Antwerpen, 2020 Antwerp, Belgium

agostonipf@gmail.com

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Drug eluting and bare metal stents in people with and without diabetes: collaborative network meta-analysis: Christoph Stettler, Sabin Allemann, Simon Wandel, Adnan Kastrati, Marie Claude Morice, Albert Schömig, Matthias E Pfisterer, Gregg W Stone, Martin B Leon, José Suárez de Lezo, Jean-Jacques Goy, Seung-Jung Park, Manel Sabaté, Maarten J Suttorp, Henning Kelbaek, Christian Spaulding, Maurizio Menichelli, Paul Vermeersch, Maurits T Dirksen, Pavel Cervinka, Marco De Carlo, Andrejs Erglis, Tania Chechi, Paolo Ortolani, Martin J Schalij, Peter Diem, Bernhard Meier, Stephan Windecker, and Peter Jüni
BMJ 2008 337: a1331. [Abstract] [Full Text] [PDF]