Three-year follow-up outcomes of SES and PES in a randomized controlled study stratified by the presence of diabetes mellitus: J-DEsSERT trial
Autor: | Masahiko Ochiai, Shinsuke Nanto, Shigenori Ito, Hiroaki Takashima, Akira Miyamoto, Ryuta Asano, Toshiya Muramatsu, Hiroshi Ohira, Yutaka Matsuyama, Takahisa Yamada, Masato Nakamura, Hiroshi Fujita, Yoshio Yasumura, Hidenari Hozawa, Nobuo Shiode, Satoru Suwa, Yoshiaki Tsukamoto, Hisayuki Okada, Hiroyoshi Yokoi, Hiroaki Mukawa, Takayuki Ogawa, Kazuya Kawai, Masaki Awata |
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Rok vydání: | 2016 |
Předmět: |
Male
Cardiovascular event medicine.medical_specialty Paclitaxel Target vessel 030204 cardiovascular system & hematology law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Randomized controlled trial law Diabetes mellitus Internal medicine Diabetes Mellitus medicine Humans 030212 general & internal medicine Aged Sirolimus business.industry Incidence (epidemiology) Drug-Eluting Stents Middle Aged medicine.disease Surgery Treatment Outcome chemistry Cardiology Female Cardiology and Cardiovascular Medicine business Mace Follow-Up Studies medicine.drug |
Zdroj: | International Journal of Cardiology. 208:4-12 |
ISSN: | 0167-5273 |
Popis: | Background Three-year clinical follow-up of patients with diabetes mellitus (DM) in the Japan-Drug Eluting Stents Evaluation; a Randomized Trial (J-DESsERT) using 2 different drug eluting stents (DES). A recent study demonstrated that efficacy of sirolimus eluting stents (SES) attenuated over time in diabetic patients. Methods In the largest trial of its kind, 1724 DM patients out of 3533 enrolled patients were randomized to either SES or paclitaxel eluting stents (PES). Results There were no significant differences in baseline clinical characteristics aside from hypertension. Incidence of major adverse cardiac cerebrovascular events (MACCE) mainly due to higher target vessel failure (TVF) initially indicated a benefit in SES (MACCE rate at 1year: SES 9.4%, PES 12.2%, p =0.08); however this had attenuated by the time of the 3-year follow-up (MACCE rate from 1 to 3years: SES 8.4%, PES 6.1%, p =0.10). A similar pattern was observed in insulin-treated patients: MACCE rate from 1 to 3years was 10.5% in SES and 6.4% in PES ( p =0.25). Angiographic follow-up also resulted in higher major adverse cardiac event (MACE) rates at 1year (presence 11.5%, absence 8.3%, p =0.04); however by 3years rates were similar regardless of the presence of angiographic follow-up (MACE rate at 3years: presence 16.0%, absence 14.5%, p =0.35). Conclusions The superiority of SES over PES in MACCE at 1year had attenuated by 3-year follow-up. Eventually, the 3-year safety and efficacy profiles were similar regardless of insulin treatment. |
Databáze: | OpenAIRE |
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