Sirolimus-eluting stents inhibit neointimal hyperplasia in diabetic patients: Insights from the RAVEL trial

• Published in: European heart journal 2004, Vol.25 (2), p.107-112
• Main Authors: ABIZAID, Alexandre, COSTA, Marco A, WIETZE, Lindeboom, SOUSA, J. Eduardo, SERRUYS, Patrick W, MORICE, Marie-Claude, BLANCHARD, Didier, ALBERTAL, Mariano, ELTCHANINOFF, Hélèn, GUAGLIUMIE, Giulio, GEERT-JAN, Laarman, ABIZAID, Andréa S, SOUSA, Amanda G. M. R, WUELFERT, Egon
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cardiology. Vascular system; Coronary Restenosis - pathology; Coronary Restenosis - prevention & control; Coronary Stenosis - drug therapy; Coronary Stenosis - pathology; Diabetic Angiopathies - drug therapy; Disease-Free Survival; Female; Follow-Up Studies; Humans; Hyperplasia - drug therapy; Immunosuppressive Agents - administration & dosage; Male; Medical sciences; Middle Aged; Sirolimus - administration & dosage; Stents; Tunica Intima - pathology
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1016/j.ehj.2003.11.002

Patients with diabetes mellitus have less favourable outcomes after percutaneous coronary intervention (PCI) than non-diabetics. We performed a subgroup analysis of the multicentre RAVEL trial to examine the impact of the sirolimus-eluting stent (SES) on outcomes in diabetic patients. The RAVEL study randomized 238 patients to treatment with either sirolimus-eluting or bare metal stents. Forty-four patients were diabetic; 19 received sirolimus-eluting stents and 25 were treated with bare metal stents. The differences in outcomes between diabetic and non-diabetic patients treated with SES (n=101) were also assessed. Follow-up angiography was performed at 6 months. Major adverse cardiac events (MACE) defined as death, myocardial infarction (MI), or target lesion revascularization (TLR) were analysed at 12-month follow-up. Six-month in-stent late lumen loss was significantly lower for the diabetic SES than the bare stent group (0.07+/-0.2 vs 0.82+/-0.5mm; P