Second-generation versus first-generation drug-eluting stents in patients with and without diabetes mellitus: pooled analysis from the RESET and NEXT trials

被引：9

作者：

Nakatsuma K. ^{[1
]}

Shiomi H. ^{[1
]}

Natsuaki M. ^{[2
]}

Morimoto T. ^{[3
]}

Igarashi K. ^{[4
]}

Kadota K. ^{[5
]}

Muramatsu T. ^{[6
]}

Tanabe K. ^{[7
]}

Morino Y. ^{[8
]}

Akasaka T. ^{[9
]}

Nakagawa Y. ^{[10
]}

Kozuma K. ^{[11
]}

Kimura T. ^{[1
]}

机构：

[1] Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto

[2] Division of Cardiology, Saiseikai Fukuoka General Hospital, Fukuoka

[3] Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya

[4] Division of Cardiology, Japan Community Health CARE Organization Hokkaido Hospital, Sapporo

[5] Department of Cardiology, Kurashiki Central Hospital, Kurashiki

[6] Division of Cardiology, Tokyo General Hospital, Tokyo

[7] Division of Cardiology, Mitsui Memorial Hospital, Tokyo

[8] Department of Cardiovascular Medicine, Iwate Medical University, Morioka

[9] Department of Cardiovascular Medicine, Wakayama Medical University Hospital, Wakayama

[10] Division of Cardiology, Tenri Hospital, Tenri

[11] Division of Cardiology, Teikyo University Hospital, Tokyo

来源：

Cardiovascular Intervention and Therapeutics | 2018年 / 33卷 / 2期

关键词：

Angioplasty; Diabetes mellitus; Drug-eluting stents;

D O I：

10.1007/s12928-017-0458-9

中图分类号：

学科分类号：

摘要：

The impact of second-generation drug-eluting stent (G2-DES) implantations compared with first-generation drug-eluting stents (G1-DES) implantations on long-term clinical outcomes after percutaneous coronary intervention in patients with and without diabetes mellitus (DM) has not yet been adequately assessed. This pooled analysis compared 3-year clinical outcomes between G1- and G2-DES according to the presence or absence of DM, using individual patient-level data from the RESET and NEXT trials. Among 6431 patients, G1-DES and G2-DES were used in 713 and 2211 patients, respectively, in the DM stratum, and 887 and 2620 patients, respectively, in the non-DM stratum. Cumulative incidence of and adjusted hazard ratio (HR) for target-lesion revascularization (TLR) were not significantly different between G2- and G1-DES in both strata [DM, 8.7 versus 10.1%, adjusted HR: 0.80, 95% confidence interval (CI) 0.59–1.10, P = 0.17; non-DM, 5.7 versus 6.2%, adjusted HR: 0.86, 95% CI 0.62–1.22, P = 0.38]. In the insulin-treated DM (ITDM), G2-DES had a significantly lower adjusted HR for TLR compared with G1-DES, although there was no significant difference in the non-ITDM (ITDM, adjusted HR: 0.54, 95% CI 0.32–0.96, P = 0.04; non-ITDM, adjusted HR: 0.95, 95% CI 0.66–1.42, P = 0.81). G2-DES provided similar risk for TLR in non-ITDM and non-DM patients compared with G1-DES. However, G2-DES compared with G1-DES had a lower risk for TLR among ITDM patients. © 2017, Japanese Association of Cardiovascular Intervention and Therapeutics.

引用

页码：125 / 134

页数：9

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