Drug-Coated Heart Stents Best for Diabetics

For people with diabetes undergoing angioplasty to clear clogged coronary arteries, stents that release a drug, sirolimus, to prevent re-clogging are better than bare-metal stents by 27% in preventing major cardiac adverse events as– cardiac death,

People with diabetes and coronary artery disease tend to have worse long-term outcomes after angioplasty than do non-diabetic patients, Dr. Manel Sabate, from San Carlos University Hospital in Madrid, and his associates explain.

In a multicenter study, reported in the American Heart Association’s journal Circulation, Sabate’s group treated 160 diabetic patients with either a sirolimus-coated stent or a standard stent. Otherwise, treatment was similar in the two groups.

At the 9-month follow-up point, narrowing of the affected artery was reduced from an average of 0.47 mm in the standard stents to 0.06 mm in the sirolimus stents.

The rate of major cardiac adverse events, such as heart-related death, heart attack, or the need for repeat procedures, was also significantly lower in the sirolimus stent group compared with the standard stent (10 percent versus 36 percent).

The investigators conclude that "sirolimus stent implantation is safe and efficacious" compared with standard stents in reducing re-blockage of coronary arteries in patients with diabetes.
Circulation, October 4, 2005.

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