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Midterm angiographic outcomes with sirolimus- and everolimus-eluting stents for small vessels in diabetic patients: propensity-score-matched comparisons in three different vessel diameters

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Abstract

We conducted propensity-score-matched comparisons of midterm angiographic follow-up outcomes of sirolimus- versus everolimus-eluting stents (SES, EES) after elective placements for de novo coronary stenosis in small vessels (SV) in patients with diabetes mellitus (DM), because the angiographic efficacy of EES over SES for those cohorts remained unclear. The study was a non-randomized, retrospective, lesion-based, multicenter study, examining lesions followed up angiographically within 550 days, extracted from the unified database of 6 institutes. The endpoint (binary restenosis) was defined as the percentage of subjects having >50% diameter stenosis at follow-up. Propensity-score-matched analyses were conducted in 3 different vessel-size cohorts, defined by a preprocedural reference diameter (RD) <2.10, <2.35, and <2.60 mm, yielding group sizes of n = 107, 183, and 312 baseline-adjusted lesions in each of the 2 stent arms. The frequency of binary restenosis decreased significantly with increasing vessel size, at 16.8, 12.6, and 12.2%, in the SES group. However, it remained almost the same across vessel-size groups in the EES group (8.0, 6.0, and 7.5%). The p values for the significance of the differences in binary restenosis between EES and SES in each vessel size increased with the decrease in vessel size [p = 0.002, 0.040, and 0.063 (the last still nearly significant)]. Thus, in patients with DM, EES showed increasingly superior efficacy over SES for SV stenosis as the vessel size became smaller, i.e., the risk for binary restenosis became greater.

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Acknowledgements

This study was supported by a research fund from Saitama Cardiovascular Respiratory Center under Grants 13EC, 14EF, 15 EB, and 16 EB to T.I.

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, Jikei University, Kashiwa Hospital, 163-1 Kashiwa-shita, Kashiwa, Chiba, 267-0004, Japan

    Kenichiro Suzuki, Tetsuya Ishikawa, Takeyuki Kubota & Kimiaki Komukai

  2. Division of Cardiology, Saitama Cardiovascular Respiratory Center, Kumagaya, Saitama, Japan

    Tetsuya Ishikawa & Makoto Mutoh

  3. Division of Cardiology, Fuji City General Hospital, Fuji, Shizuoka, Japan

    Hiroshi Sakamoto

  4. Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan

    Takayuki Ogawa & Michihiro Yoshimura

  5. Division of Cardiology, Department of Internal Medicine, Jikei University School of Medicine, Daisan Hospital, Tokyo, Japan

    Chikara Mori

  6. Division of Cardiology, Nishisaitama-chuo National Hospital, Tokorozawa, Saitama, Japan

    Koichi Hashimoto

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  1. Kenichiro Suzuki
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  2. Tetsuya Ishikawa
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  3. Makoto Mutoh
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  4. Hiroshi Sakamoto
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  5. Takeyuki Kubota
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  6. Takayuki Ogawa
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  7. Chikara Mori
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  8. Koichi Hashimoto
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  9. Kimiaki Komukai
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  10. Michihiro Yoshimura
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On behalf of a Multicenter Registry in The Jikei University

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Correspondence to Tetsuya Ishikawa.

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Suzuki, K., Ishikawa, T., Mutoh, M. et al. Midterm angiographic outcomes with sirolimus- and everolimus-eluting stents for small vessels in diabetic patients: propensity-score-matched comparisons in three different vessel diameters. Cardiovasc Interv and Ther 33, 205–216 (2018). https://doi.org/10.1007/s12928-017-0466-9

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  • DOI: https://doi.org/10.1007/s12928-017-0466-9

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