Impact of diabetes mellitus on one-year outcomes of bioresorbable versus durable polymer drug-eluting stents in patients undergoing percutaneous coronary intervention following rotational atherectomy: Results from a large prospective registry
Year: 2025
Type: article
Study design: Observational Study
Abstract: Patients with diabetes mellitus (DM) have worse outcomes after percutaneous coronary intervention (PCI), even with everolimus-eluting stents (EES). Limited data are available comparing outcomes in DM versus non-DM receiving various bioresorbable polymer (BP) or durable polymer (DP) EES after rotational atherectomy (RA). We aimed to study the impact of DM on outcomes in patients undergoing PCI with BP-EES and DP-EES after RA. Consecutive patients undergoing PCI with RA between 2014 and 2021 were included. The primary outcome was major adverse cardiac events (MACE), a composite of death, myocardial infarction (MI), or stroke at 1 year, which was stratified according to DM status. Regression analysis was performed to adjust for confounders. Among 2376 patients (mean age 70.3 ± 10.7, 49.5 % DM) that underwent RA, 552 received BP-EES and 1824 received DP-EES. Both groups had similar number of stents implanted and stent diameters; however, the BP-EES group had a higher SYNTAX score and was more likely to have multi-vessel disease and undergo PCI to the left anterior descending, circumflex, and right coronary artery. In both BP-EES and DP-EES groups, there was no significant difference in adjusted risk of MACE (BP-EES: 7.3 % vs. 7.1 %, HR 0.78, 95 % CI 0.35–1.78, P = 0.562 & DP-EES: 7.5 % vs. 3.7 %, HR 1.49, 95 % CI 0.89–2.50, P = 0.130) between diabetics and non-diabetics. Despite differences in baseline characteristics, DM was not associated with worse MACE at one year in patients with complex coronary artery disease undergoing RA and PCI with contemporary BP-EES or DP-EES.
Authors: Matthew Siano, Rakhee Makhija, Neel Patel, Samantha Sartori, Serdar Farhan, David Power, Yihan Feng, Wen Chang, Anton Camaj, Frank Kalaba, Vishal Dhulipala, Keisuke Yasumura, Roja Thapi, Pooja Vijay, Nikito Gurung, Manish Vinayak, Amit Hooda, Parasuram Krishnamoorthy, Joseph Sweeny, George Dangas, Roxana Mehran, Annapoorna Kini, Samin Sharma
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,810
OpenAlex ID: W4416024131