Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/1418
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dc.contributorBlusztein, D.en_US
dc.contributorBiswas, S.en_US
dc.contributorLefkovits, J.en_US
dc.contributorAjani, A.en_US
dc.contributorBrennan, A.en_US
dc.contributorStub, D.en_US
dc.contributorDuffy, S.en_US
dc.contributorChan, W.en_US
dc.contributorClark, D.en_US
dc.contributorFreeman, M.en_US
dc.contributorOqueli, Ernestoen_US
dc.contributorReid, C.en_US
dc.contributorYudi, M.en_US
dc.contributorHutchison, A.en_US
dc.contributorDawson, L.en_US
dc.contributorMurphy, A.en_US
dc.contributorEccleston, D.en_US
dc.date.accessioned2019-10-16T03:05:37Z-
dc.date.available2019-10-16T03:05:37Z-
dc.date.issued2019-
dc.identifier.govdoc01377en_US
dc.identifier.urihttp://hdl.handle.net/11054/1418-
dc.description.abstractBackground: Patients with diabetes mellitus (DM) have increased adverse events post percutaneous coronary intervention (PCI), somewhat attenuated by use of drug-eluting stents (DES). DES choice is controversial, with studies showing increased late mortality with sirolimus-eluting stents (SES) compared to paclitaxel-eluting (PES) or bare-metal stents (BMS) and higher major adverse cardiac and cerebrovascular event (MACCE) rates with second generation everolimus (EES) vs. PES. Methods: We enrolled 4,579 diabetic patients undergoing PCI from 2005-2014 in the Melbourne Interventional Group registry. Characteristics and 12-month outcomes were compared between insulin-treated (ITDM) and non-ITDM patients and by stent type. Results: Diabetics receiving DES were more likely to be insulin-requiring ( p < 0.05) or undergoing PCI for restenosis ( p < 0.001). ST-elevation myocardial infarction (STEMI) patients more often received BMS ( p < 0.003 for SES and PES); even after propensity matching in STEMI, a significant hazard for MACCE in ITDM vs. non-ITDM patients (OR 1.48, 1.19-1.84) remained. Stents were longer and vessel size smaller in DES vs. BMS ( p < 0.0001). However, 12-month MACCE were higher in BMS vs. SES or PES ( p = 0.004 and p = 0.046) and did not differ between DES types. Conclusion: In ITDM, all DES resulted in lower 12 month MACCE than BMS. Overall, outcomes depend more on the presence and intensity of DM treatment than stent type, particularly for EES vs. PES or second-generation vs. first generation DES.en_US
dc.description.provenanceSubmitted by Gemma Siemensma (gemmas@bhs.org.au) on 2019-07-30T05:49:10Z No. of bitstreams: 0en
dc.description.provenanceApproved for entry into archive by Gemma Siemensma (gemmas@bhs.org.au) on 2019-10-16T03:05:37Z (GMT) No. of bitstreams: 0en
dc.description.provenanceMade available in DSpace on 2019-10-16T03:05:37Z (GMT). No. of bitstreams: 0 Previous issue date: 2019en
dc.relation.urihttp://dx.doi.org/10.1016/j.hlc.2019.06.713en_US
dc.titleWhat is the optimal drug-eluting stent for percutaneous coronary intervention in patients with insulin-treated vs. non-insulin treated diabetes?en_US
dc.typeConferenceen_US
dc.type.specifiedPresentationen_US
dc.bibliographicCitation.conferencedateAugust 8th-11then_US
dc.bibliographicCitation.conferencename67th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, the International Society for Heart Research Australasian Section Annual Scientific Meeting and the 13th Annual Australia and New Zealand Endovascular Therapies Meeting.en_US
dc.bibliographicCitation.conferenceplaceAdelaide, Australiaen_US
dc.subject.healththesaurusDIABETES MELLITUSen_US
dc.subject.healththesaurusPOST PERCUTANEOUS CORONARY INTERVENTIONen_US
dc.subject.healththesaurusDRUG-ELUTING STENTSen_US
dc.subject.healththesaurusSIROLIMUS-ELUTING STENTSen_US
dc.subject.healththesaurusPACLITAXEL-ELUTING STENTSen_US
dc.subject.healththesaurusBARE-METAL STENTSen_US
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