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Sirolimus eluting stent (Cypher™) in patients with diabetes mellitus: results from the German Cypher Stent Registry

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Abstract

Background

Patients with diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI) are at increased risk for adverse outcomes. The use of sirolimus eluting stents (SES) has been shown to improve outcomes in diabetic patients. Since results from randomized trials were derived from selected patients scientific scrutiny under real world conditions is necessary.

Methods and results

1,948 patients with DM and 4,707 patients without DM were included in the German Cypher Registry, a post-marketing survey of use of SES in Germany. In >99% of entry cases a structured clinical follow-up was completed. By angiographic criteria severity of coronary artery disease was higher in diabetic patients compared to non-diabetics. However, procedural success and in-hospital complication rates were comparable between DM- and non-DM-patients. 6 months MACE rate in the DM group was significantly higher than in the non-DM group (16.4% vs. 13.0%) but lower than expected from historical data with the use of bare metal stents (BMS).

Conclusion

The results with SES in diabetics are encouraging but DM remains a risk factor for poor outcome of PCI. No statement is justified whether the treatment of diabetics with SES is at least as safe as bypass surgery. This intriguing question has to be answered in a direct randomized head-to-head comparison with state of the art surgery.

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Authors and Affiliations

  1. Department of Internal Medicine, Frankenwaldklinik Kronach, Friesener Strasse 41, 96317, Kronach, Germany

    Frank D. Weber MD

  2. Department of Internal Medicine, Division of Cardiology, University Hospital Rostock, Rostock, Germany

    Henrik Schneider & Christoph A. Nienaber

  3. Heart and Diabetes Center NRW, Bad Oeynhausen, Germany

    Marcus Wiemer

  4. Cordis Germany, Langenfeld, Germany

    Thomas Pfannebecker

  5. Department of Internal Medicine II-Cardiology, Hospital Lippe, Detmold, Germany

    Ulrich Tebbe

  6. Department of Cardiology, Kerckhoff-Clinic, Bad Nauheim, Germany

    Christian W. Hamm

  7. Department of Cardiology, Heart Center Ludwigshafen, Ludwigshafen, Germany

    Jochen Senges & Steffen Schneider

Authors
  1. Frank D. Weber MD
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  2. Henrik Schneider
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  3. Marcus Wiemer
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  4. Thomas Pfannebecker
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  5. Ulrich Tebbe
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  6. Christian W. Hamm
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  7. Jochen Senges
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  8. Steffen Schneider
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  9. Christoph A. Nienaber
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Corresponding author

Correspondence to Frank D. Weber MD.

Additional information

All the authors belong to German Cypher™ Registry.

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Weber, F.D., Schneider, H., Wiemer, M. et al. Sirolimus eluting stent (Cypher™) in patients with diabetes mellitus: results from the German Cypher Stent Registry. Clin Res Cardiol 97, 105–109 (2008). https://doi.org/10.1007/s00392-007-0595-8

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  • DOI: https://doi.org/10.1007/s00392-007-0595-8

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