Biodegradable polymer drug-eluting stents versus second-generation drug-eluting stents in patients with and without diabetes mellitus: a single-center study

Tang, Xiaofang; Ma, Yan; Song, Ying; Yao, Yi; He, Chen; Wang, Huanhuan; Jiang, Ping; Jiang, Lin; Liu, Ru; Gao, Zhan; Zhao, Xueyan; Qiao, Shubin; Yang, Yuejin; Gao, Runlin; Xu, Bo

doi:10.1186/s12933-018-0758-0

Cited by 10 publications

(8 citation statements)

References 47 publications

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“…Very late (0) (0) In the present analysis, diabetic patients treated with EES showed clinical event rates similar to those of the EES-treated diabetic patients in a pooled analysis of the SPIRIT and COMPARE trials (6). Furthermore, in our patients with diabetes the efficacy and short-and long-term safety of EE-BRS treatment were favorable and comparable to previous studies (24)(25)(26)(27). The performance of EE-BRS and EES have been compared in non-exclusive diabetes populations.…”

Section: Discussionsupporting

confidence: 85%

Everolimus-eluting bioresorbable scaffolds and metallic stents in diabetic patients: a patient-level pooled analysis of the prospective ABSORB DM Benelux Study, TWENTE and DUTCH PEERS

Hommels

Hermanides

Berta

et al. 2020

Preprint

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Background Several studies compared everolimus-eluting bioresorbable scaffolds (EE-BRS) with everolimus-eluting stents (EES), but only few assessed these devices in patients with diabetes mellitus. Aim To evaluate the safety and efficacy outcomes of all-comer patients with diabetes up to 2 years after treatment with EE-BRS or EES. Methods We performed a post-hoc pooled analysis of patient-level data in diabetic patients who were treated with EE-BRS or EES in 3 prospective clinical trials: The ABSORB DM Benelux Study (NTR5447), TWENTE (NTR1256/NCT01066650) and DUTCH PEERS (NTR2413/NCT01331707). Primary endpoint of the analysis was target lesion failure (TLF): a composite of cardiac death, target vessel myocardial infarction or clinically driven target lesion revascularization. Secondary endpoints included major adverse cardiac events (MACE): a composite of all-cause death, any myocardial infarction or clinically driven target vessel revascularization, as well as definite or probable device thrombosis (ST). Results A total of 499 diabetic patients were assessed, of whom 150 received EE-BRS and 249 received EES. Total available follow-up was 222.6 patient years (PY) in EE-BRS and 464.9 PY in EES. The adverse events rates were similar in both treatment groups for TLF (7.2 vs. 5.2 events per 100 PY, p=0.39; adjusted hazard ratio (HR)=1.48 (95% confidence interval (CI): 0.77-2.87), p=0.24), MACE (9.1 vs. 8.3 per 100 PY, p=0.83; adjusted HR=1.23 (95% CI: 0.70-2.17), p=0.47), and ST (0.9 vs. 0.6 per 100 PY, p>0.99). Conclusion In this patient-level pooled analysis of patients with diabetes mellitus from 3 clinical trials, EE-BRS showed clinical outcomes that were quite similar to EES.

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Section: Discussionsupporting

confidence: 85%

Everolimus-eluting bioresorbable scaffolds and metallic stents in diabetic patients: a patient-level pooled analysis of the prospective ABSORB DM Benelux Study, TWENTE and DUTCH PEERS

Hommels

Hermanides

Berta

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In the present analysis, diabetic patients treated with EES showed clinical event rates similar to those of the EES-treated diabetic patients in a pooled analysis of the SPIRIT and COMPARE trials (6). Furthermore, in our patients with diabetes the e cacy and short-and long-term safety of EE-BRS treatment were favorable and comparable to previous studies (21)(22)(23)(24). The performance of EE-BRS and EES have been compared in non-exclusive diabetes populations.…”

Section: Discussionsupporting

confidence: 82%

Everolimus-Eluting Bioresorbable Scaffolds and Metallic Stents in Diabetic Patients: a Patient-level Pooled Analysis of the Prospective ABSORB DM Benelux Study, TWENTE and DUTCH PEERS

Hommels

Hermanides

Berta

et al. 2020

Preprint

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Abstract Background: Several studies compared everolimus-eluting bioresorbable scaffolds (EE-BRS) with everolimus-eluting stents (EES), but only few assessed these devices in patients with diabetes mellitus.Aim: To evaluate the safety and efficacy outcomes of all-comer patients with diabetes up to 2 years after treatment with EE-BRS or EES.Methods: We performed a post-hoc pooled analysis of patient-level data in diabetic patients who were treated with EE-BRS or EES in 3 prospective clinical trials: The ABSORB DM Benelux Study (NTR5447), TWENTE (NTR1256/NCT01066650) and DUTCH PEERS (NTR2413/NCT01331707). Primary endpoint of the analysis was target lesion failure (TLF): a composite of cardiac death, target vessel myocardial infarction or clinically driven target lesion revascularization. Secondary endpoints included major adverse cardiac events (MACE): a composite of all-cause death, any myocardial infarction or clinically driven target vessel revascularization, as well as definite or probable device thrombosis (ST).Results: A total of 499 diabetic patients were assessed, of whom 150 received EE-BRS and 249 received EES. Total available follow-up was 222.6 patient years (PY) in EE-BRS and 464.9 PY in EES. The adverse events rates were similar in both treatment groups for TLF (7.2 vs. 5.2 events per 100 PY, p=0.39; adjusted hazard ratio (HR)=1.48 (95% confidence interval (CI): 0.77-2.87), p=0.24), MACE (9.1 vs. 8.3 per 100 PY, p=0.83; adjusted HR=1.23 (95% CI: 0.70-2.17), p=0.47), and ST (0.9 vs. 0.6 per 100 PY, p>0.99).Conclusion: In this patient-level pooled analysis of patients with diabetes mellitus from 3 clinical trials, EE-BRS showed clinical outcomes that were quite similar to EES.

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“…China has over 92.4 million diabetic patients (9.7% of the adult population), which ranks at the top with DM patient numbers and higher diabetes-related burden than other countries [25]. A single-centre study from Fuwai Hospital of China [26] reported that second-generation drug-eluting stents have reliable efficacy and safety in diabetic and non-diabetic patients. In the subgroup analysis of diabetic patients, the risk factors associated with target lesion revascularization included current smoker, a history of coronary heart disease, and old myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

Remnant lipoproteins play an important role of in-stent restenosis in type 2 diabetes undergoing percutaneous coronary intervention: a single-centre observational cohort study

Qin

Zhou

Liu

et al. 2019

Cardiovasc Diabetol

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BackgroundIncreasing evidence has suggested that the presence of remnant lipoproteins is a significant risk factor for atherosclerosis. Remnant lipoproteins are lipoproteins that are rich in triglycerides (TGs), and the main components include very-low-density lipoprotein (VLDL) in the fasting state. Diabetic patients often have hypertriglyceridemia with elevated levels of VLDL cholesterol but normal levels of low-density lipoprotein cholesterol (LDL-C). The aim of the present study was to elucidate the potential role of remnant lipoproteins-induced atherosclerosis in the occurrence and development of in-stent restenosis (ISR) in diabetic patients with coronary artery disease.MethodsThe present study enrolled 2312 patients with type 2 diabetes mellitus who underwent percutaneous coronary intervention from January 2013 to December 2014 and who were followed up by angiography. Patients were divided into two groups based on the presence or absence of ISR, and multivariate Cox’s proportional hazards regression modelling showed that remnant-like particle cholesterol (RLP-C) was an independent risk factor for ISR. According to the receiver operating characteristic curve, the optimal cutoff point of the RLP-C was identified, and the patients were further divided into 2 groups. Propensity score matching analysis was performed, and 762 pairs were successfully matched. Log-rank tests were used to compare Kaplan–Meier curves for overall follow-up to assess ISR.ResultsThe multivariate Cox’s proportional hazards regression analysis showed that RLP-C was independently associated with ISR, and the baseline RLP-C level at 0.505 mmol/L was identified as the optimal cutoff point to predict ISR. Patients were divided into 2 groups by RLP levels. After propensity score matching analysis, a total of 762 pairs matched patients were generated. Kaplan–Meier curves showed that the estimated cumulative rate of ISR was significantly higher in patients with RLP-C levels ≥ 0.505 mmol/L (log-rank P < 0.001; HR equal to 4.175, 95% CI = 3.045–5.723, P < 0.001) compared to patients with RLP-C levels < 0.505 mmol/L.ConclusionsThe present study emphasized the importance of remnant-like particle cholesterol in cardiovascular pathology in diabetic patients. Physicians should take measures to control RLP-C below the level of 0.505 mmol/L to better prevent of in-stent restenosis in diabetic patients.

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Biodegradable polymer drug-eluting stents versus second-generation drug-eluting stents in patients with and without diabetes mellitus: a single-center study

Cited by 10 publications

References 47 publications

Everolimus-eluting bioresorbable scaffolds and metallic stents in diabetic patients: a patient-level pooled analysis of the prospective ABSORB DM Benelux Study, TWENTE and DUTCH PEERS

Everolimus-eluting bioresorbable scaffolds and metallic stents in diabetic patients: a patient-level pooled analysis of the prospective ABSORB DM Benelux Study, TWENTE and DUTCH PEERS

Everolimus-Eluting Bioresorbable Scaffolds and Metallic Stents in Diabetic Patients: a Patient-level Pooled Analysis of the Prospective ABSORB DM Benelux Study, TWENTE and DUTCH PEERS

Remnant lipoproteins play an important role of in-stent restenosis in type 2 diabetes undergoing percutaneous coronary intervention: a single-centre observational cohort study

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