Clinical Outcome of Diabetic Patients Treated by Percutaneous Coronary Intervention Using Drug-Eluting and Bare Metal Stents

ABSTRACTBackgroundPercutaneous revascularization in diabetic is frequent and the use of drug-eluting stents (DES) is desirable, since they reduce restenosis and the need for repeat revascularization. The objective of this study was to compare the long-term outcomes of diabetic patients treated with and without DES.MethodsA consecutive cohort of diabetic patients undergoing percutaneous coronary intervention (PCI) between January 2009 and December 2012 in a public tertiary hospital was prospectively followed-up.ResultsNine hundred and thirty-nine diabetic patients (38.3%) treated with DES and 580 (61.7%) treated with bare metal stents (BMS) were evaluated. The rate of major adverse cardiac events (MACE) in 12.6±3.4months was greater in the BMS group (9.5% vs. 14.8%; RR, 1.56; 95% CI, 1.07-2.27; P=0.02), as well as death (2.8% vs. 6.7%; RR, 2.41; 95% CI, 1.22-4.77; P<0.01), and target vessel revascularization (3.9% vs. 7.2%; RR, 1.85; 95% CI, 1.03-3.35; P=0.04). There were no differences in the incidence of myocardial infarction (1.7% vs. 0.5%; RR, 0.30; 95% CI, 0.07-1.23; P=0.08) or stroke (1.1% vs. 0.2%; RR, 0.15; 95% CI, 0.01-1.37; P=0.07). Multivariate analysis indicated that chronic kidney disease (RR, 2.05; 95% CI, 1.40-2.98; P<0.01) and acute coronary syndrome (RR, 2.08; 95% CI 1.42-3.02; P