Cardiovascular Intervention and Therapeutics

, Volume 33, Issue 2, pp 125–134 | Cite as

Second-generation versus first-generation drug-eluting stents in patients with and without diabetes mellitus: pooled analysis from the RESET and NEXT trials

  • Kenji Nakatsuma
  • Hiroki Shiomi
  • Masahiro Natsuaki
  • Takeshi Morimoto
  • Keiichi Igarashi
  • Kazushige Kadota
  • Toshiya Muramatsu
  • Kengo Tanabe
  • Yoshihiro Morino
  • Takashi Akasaka
  • Yoshihisa Nakagawa
  • Ken Kozuma
  • Takeshi Kimura
  • On behalf of the RESET and NEXT investigators
Original Article


The impact of second-generation drug-eluting stent (G2-DES) implantations compared with first-generation drug-eluting stents (G1-DES) implantations on long-term clinical outcomes after percutaneous coronary intervention in patients with and without diabetes mellitus (DM) has not yet been adequately assessed. This pooled analysis compared 3-year clinical outcomes between G1- and G2-DES according to the presence or absence of DM, using individual patient-level data from the RESET and NEXT trials. Among 6431 patients, G1-DES and G2-DES were used in 713 and 2211 patients, respectively, in the DM stratum, and 887 and 2620 patients, respectively, in the non-DM stratum. Cumulative incidence of and adjusted hazard ratio (HR) for target-lesion revascularization (TLR) were not significantly different between G2- and G1-DES in both strata [DM, 8.7 versus 10.1%, adjusted HR: 0.80, 95% confidence interval (CI) 0.59–1.10, P = 0.17; non-DM, 5.7 versus 6.2%, adjusted HR: 0.86, 95% CI 0.62–1.22, P = 0.38]. In the insulin-treated DM (ITDM), G2-DES had a significantly lower adjusted HR for TLR compared with G1-DES, although there was no significant difference in the non-ITDM (ITDM, adjusted HR: 0.54, 95% CI 0.32–0.96, P = 0.04; non-ITDM, adjusted HR: 0.95, 95% CI 0.66–1.42, P = 0.81). G2-DES provided similar risk for TLR in non-ITDM and non-DM patients compared with G1-DES. However, G2-DES compared with G1-DES had a lower risk for TLR among ITDM patients.


Diabetes mellitus Angioplasty Drug-eluting stents 



We appreciate the effort of the members of the cardiac catheterization laboratory and clinical research coordinators in the participating centers. A list of all RESET and NEXT Investigators is given in the Appendix in the Data Supplement (Supplemental Appendix A and B).

Compliance with ethical standards

Sources of funding

The Abbott Vascular Japan (Tokyo, Japan) and Terumo (Tokyo, Japan).

Conflict of interest

Dr. Kozuma and Dr. Tanabe have served on the advisory boards of Abbott Vascular and Terumo; and have received lecture fees from Abbott Vascular and Terumo. Dr. Kadota has received honoraria from Abbott Vascular and Terumo; and has served on the advisory boards of Abbott Vascular. Dr. Morino has served on the advisory board of Abbott Vascular and Terumo. Dr. T. Kimura has served on the advisory board of Terumo and Abbott Vascular. The other authors report no conflicts.

Supplementary material

12928_2017_458_MOESM1_ESM.docx (805 kb)
Supplementary material 1 (DOCX 804 kb)


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Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2017

Authors and Affiliations

  • Kenji Nakatsuma
    • 1
  • Hiroki Shiomi
    • 1
  • Masahiro Natsuaki
    • 2
  • Takeshi Morimoto
    • 3
  • Keiichi Igarashi
    • 4
  • Kazushige Kadota
    • 5
  • Toshiya Muramatsu
    • 6
  • Kengo Tanabe
    • 7
  • Yoshihiro Morino
    • 8
  • Takashi Akasaka
    • 9
  • Yoshihisa Nakagawa
    • 10
  • Ken Kozuma
    • 11
  • Takeshi Kimura
    • 1
  • On behalf of the RESET and NEXT investigators
  1. 1.Department of Cardiovascular Medicine, Graduate School of MedicineKyoto UniversityKyotoJapan
  2. 2.Division of CardiologySaiseikai Fukuoka General HospitalFukuokaJapan
  3. 3.Department of Clinical EpidemiologyHyogo College of MedicineNishinomiyaJapan
  4. 4.Division of CardiologyJapan Community Health CARE Organization Hokkaido HospitalSapporoJapan
  5. 5.Department of CardiologyKurashiki Central HospitalKurashikiJapan
  6. 6.Division of CardiologyTokyo General HospitalTokyoJapan
  7. 7.Division of CardiologyMitsui Memorial HospitalTokyoJapan
  8. 8.Department of Cardiovascular MedicineIwate Medical UniversityMoriokaJapan
  9. 9.Department of Cardiovascular MedicineWakayama Medical University HospitalWakayamaJapan
  10. 10.Division of CardiologyTenri HospitalTenriJapan
  11. 11.Division of CardiologyTeikyo University HospitalTokyoJapan

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