NEW YORK (Reuters Health) – Among diabetic patients undergoing percutaneous coronary interventions, the risk of restenosis is lower when drug-eluting stents are used than when bare-metal stents are used, according to the results of a meta-analysis of randomized studies.
In general, say the researchers, patients with diabetes who are treated with bare metal stents are at markedly high risk of restenosis.
"While diabetics were enrolled in most trials of drug-eluting stents," lead investigator Dr. Hitinder S. Gurm told Reuters Health, "none of (the trials) were powered to show benefits in this complex group of patients."
To deal with this limitation, Dr. Gurm of the University of Michigan, Ann Arbor and colleagues pooled data from 8 trials involving 1520 diabetic patients. The results are reported in the May 15th issue of the American Journal of Cardiology.
"We found," continued Dr. Gurm, "that use of drug-eluting stents reduced the need for repeat procedures by 65%."
"One concern that has recently emerged relates to late stent thrombosis," he added. "In this study, there was no difference in survival with either type of stent. However, our study follow-up was too short to detect a difference in survival."
"Longer-term studies are needed to assess if there are any downsides to use of drug-eluting stents in diabetics." Nevertheless, he concluded, "short-term data overwhelmingly support use of drug-eluting stents in this group of patients."
–David Douglas
