Two-year results of paclitaxel-eluting stents in patients with medically treated diabetes mellitus from the TAXUS ARRIVE program
Lasala JM et al. – Results suggest that TAXUS paclitaxel-eluting stents abrogate the increased diabetic risk of clinical restenosis previously reported with bare metal stents, with similar low risk of myocardial infarction or stent thrombosis for diabetic and nondiabetic pts. However, 2-yr mortality risk is still increased in diabetic pts. Methods- Study of whether paclitaxel provides equivalent revascularization decrease in diabetic and nondiabetic pts
- ARRIVE registries; 7,492 pts receiving TAXUS Express stents, including 2,112 with medically treated diabetes
- Comparison of results with remaining 5,380 nondiabetic pts
Results- Comparable 2-yr target lesion revascularization (TLR) in diabetic vs nondiabetic pts (8.2% vs 7.7%)
- Similar TLR after multivariate adjustment for baseline differences (7.1% vs 6.8%)
- No significant TLR differences between diabetic vs nondiabetic pts with small vessels (9.7% vs 9.5%) or left main coronary artery, 3-vessel, or bifurcation stenting (10.7% vs 13.1%)
- Diabetes not a significant TLR predictor
- Stent thrombosis (2.6% vs 2.4%) and myocardial infarction (3.8% vs 3.0%) rates similar for diabetic vs nondiabetic pts
- Significantly increased 2-yr mortality for diabetic vs nondiabetic pts (9.7% vs 5.3%); thus significantly increased major cardiac events in diabetic pts
- No difference in stent-related major cardiac events (8.9% vs 10.1%)
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