Comparison of in-hospital and long-term outcomes between a Cypher stent and a Taxus stent in Chinese diabetic patients with coronary artery disease

Background The sirolimus and paclitaxel distribution patterns and tissue residence time may be modified inatherosclerotic lesions for patients with diabetes,and the biological mechanisms of action for these agents differsignificantly.Previous clinical trials have yielded discrepant results of major adverse cardiac events and restenosisbetween a sirolimus-eluting stent and a paclitaxel-eluting stent in coronary artery disease.Therefore,this study wasconduced to compare in-hospital and long-term clinical outcomes between patients receiving sirolimus-eluting stent(Cypher or Cypher Select stent)and paclitaxel-eluting stent (Taxus Express stent) after percutaneous intervention (PCI)in Chinese patients with diabetes.Methods One hundred and sixty-four consecutive diabetic patients underwent PCI in Fuwai Hospital from April 2004 toDecember 2004.Of them,101 patients received Cypher or Cypher Select stents (Cypher group,145 stents) and 63patients received Taxus Express stents (Taxus group,129 stents).Repeat coronary angiography was performed at6-month and clinical outcomes were evaluated at 1-and 3-year follow-up.Stent thrombosis was classified according toAcademic Research Consortium (ARC).Results The two groups did not differ significantly with respect to cardiac death,recurrent myocardial infarction (re-MI),target vessel revascularization(TVR) and occurrence of major adverse cardiac events (MACE).And the MACE-freecumulative survival at 1-and 3-year follow-up and early,late and very late thrombosis rates were also similar in the twogroups (all P>0.05).There was a trend favoring PES over SES with regard to reducing cardiac death (0 vs 2.0%,P=0.524),re-MI (0 vs 2.0%,P=0.524),the composite of the cardiac death and re-MI (0 vs 4.0%,P=0.299) and very latethrombosis (0 vs 3.0%,P=0.295) between 1-year and 3-year follow-up.Conclusion The study indicates that PCI with either Cypher or Taxus stents is associated with similar efficacy andsafety in the small population of Chinese diabetic patients during long-term follow-up.