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More Adverse Events Noted With Stents in Diabetes Patients

However, stents and bypass surgery associated with similar rates of death, stroke, heart attack

THURSDAY, Jan. 14 (HealthDay News) -- Diabetes patients with heart disease who receive drug-eluting stents have a higher rate of major adverse events compared with those who undergo bypass surgery, although death, stroke, and heart attack rates are unaffected by revascularization method, according to a study published online Jan. 13 in the Journal of the American College of Cardiology.

Adrian P. Banning, M.D., from John Radcliffe Hospital in Oxford, U.K., and colleagues randomly assigned 1,800 patients with de novo left main and/or three-vessel disease (452 patients with medically treated diabetes) to paclitaxel-eluting stents (PES) or coronary artery bypass graft surgery (CABG).

The researchers found that the rate of death, stroke, or myocardial infarction was unaffected by revascularization method, although the overall rate was higher in patients with diabetes (10.3 percent CABG versus 10.1 percent PES) compared with patients without diabetes (6.8 percent for both methods). Mortality was significantly higher after either method of treatment. However, patients with diabetes treated with PES had a higher one-year major adverse cardiac and cerebrovascular event rate compared with CABG.

"Subgroup analyses suggest that the 1-year major adverse cardiac and cerebrovascular event rate is higher among diabetic patients with left main and/or three-vessel disease treated with PES compared with CABG, driven by an increase in repeat revascularization," Banning and colleagues conclude. "Although further study is needed, these exploratory results may extend the evidence for PES use in selected patients with less complex left main and/or three-vessel lesions."

The study was funded by Boston Scientific. Several authors reported receiving research support from Boston Scientific and several authors are employees of the company.

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