Outcomes Among Diabetic Patients Undergoing Percutaneous Coronary Intervention With Contemporary Drug-Eluting Stents
Open accessAbstract
Objectives The authors sought to investigate the impact of diabetes mellitus (DM) on outcomes following contemporary drug-eluting stent (DES) implantation in the BIONICS (BioNIR Ridaforolimus Eluting Coronary Stent System in Coronary Stenosis) trial.Background Patients with DM are at increased risk for adverse events following percutaneous coronary intervention (PCI).Methods A prospective, multicenter, 1:1 randomized trial was conducted to evaluate in a noninferiority design the safety and efficacy of ridaforolimus-eluting stents versus zotarolimus-eluting stents among 1,919 patients undergoing PCI. Randomization was stratified to the presence of medically treated DM, and a pre-specified analysis compared outcomes according to the presence or absence of DM up to 2 years.Results The overall prevalence of DM was 29.1% (559 of 1,919). DM patients had higher body mass index, greater prevalence of hyperlipidemia and hypertension, and smaller reference vessel diameter. One-year target lesion failure (cardiac death, target vessel myocardial infarction, or ischemia-driven target lesion revascularization) was significantly higher among diabetic patients (7.8% vs. 4.2%; p = 0.002), mainly due to higher target lesion revascularization (4.5% vs. 2.0%; p = 0.002). Rates of cardiac death, myocardial infarction, and stent thrombosis did not statistically vary. Among 158 patients undergoing 13-month angiographic follow-up, restenosis rates were 3 times higher in diabetic patients compared with nondiabetic patients (15.2% vs. 4.7%; p = 0.01). Clinical and angiographic outcomes were similar between ridaforolimus-eluting stent- and zotarolimus-eluting stent-treated patients.Conclusions Despite advances in interventional therapies, and the implementation of new-generation DES, diabetic patients still have worse angiographic and clinical outcomes compared with nondiabetic patients undergoing PCI.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Greater vascular disease burden and progressive coronary disease in type 2 diabetes increase the likelihood of ischemic events in target and nontarget vessels after revascularization, especially in patients with more advanced diabetes as indicated by insulin use.
“In particular, the increased vascular disease burden and progressive nature of CAD in patients with T2DM lead to an increased propensity toward postrevascularization target and nontarget vessel ischemic events, especially in those with more advanced T2DM as reflected by insulin requirements.265,297”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [297]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Clinical End Points in Coronary Stent Trials
Cutlip, D. E., Windecker, S., Mehran, R., Boam, A. B., Cohen, D. J., van Es, G., Steg, P. G., Morel, M., Mauri, L., Vranckx, P., et al. (2007) · Circulation · doi:10.1161/circulationaha.106.685313 · Cited by 5,501 · see citing works
Iakovou, I. P. (2005) · JAMA · doi:10.1001/jama.293.17.2126 · Cited by 3,136 · see citing works
Third Universal Definition of Myocardial Infarction
Thygesen, K. A., Alpert, J. S., Jaffe, A. S., Simoons, M. L., CHAITMAN, B. R., White, H. D., Thygesen, K. A., Alpert, J. S., White, H. D., Jaffe, A. S., et al. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.08.001 · Cited by 2,619 · see citing works
Angiographic Patterns of In-Stent Restenosis
Mehran, R., Dangas, G., Abizaid, A. S., et al. (1999) · Circulation · doi:10.1161/01.cir.100.18.1872 · Cited by 1,264 · see citing works
Moussa, I. D., Klein, L. W., Shah, B., Mehran, R., Mack, M. J., Brilakis, E. S., Reilly, J. P., Zoghbi, G. J., Holper, E. M., & Stone, G. W. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.08.720 · Cited by 653 · see citing works
Self-citationEffect of Diabetes Mellitus on Formation of Coronary Collateral Vessels
Abacı, A., Oğuzhan, A., Kahraman, S., Eryol, N. K., Ünal, S., Arınç, H., & Ergin, A. (1999) · Circulation · doi:10.1161/01.cir.99.17.2239 · Cited by 626 · see citing works
Coronary Angioplasty in Diabetic Patients
Kip, K. E., Faxon, D. P., Detre, K. M., Yeh, W., Kelsey, S. F., & Currier, J. W. (1996) · Circulation · doi:10.1161/01.cir.94.8.1818 · Cited by 461 · see citing works
Abizaid, A., Kornowski, R., Mintz, G. S., Hong, M. K., Abizaid, A. S., Mehran, R., Pichard, A. D., Kent, K. M., Satler, L. F., Wu, H., et al. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)00286-1 · Cited by 457 · see citing works
Self-citationKornowski, R., Mintz, G. S., Kent, K. M., Pichard, A. D., Satler, L. F., Bucher, T. A., Hong, M. K., Popma, J. J., & Leon, M. B. (1997) · Circulation · doi:10.1161/01.cir.95.6.1366 · Cited by 451 · see citing works
Self-citationCutlip, D. E., Chhabra, A., Baim, D. S., Chauhan, M. S., Marulkar, S., Massaro, J. M., Bakhai, A., Cohen, D. J., Kuntz, R. E., & Ho, K. K. L. (2004) · Circulation · doi:10.1161/01.cir.0000140721.27004.4b · Cited by 302 · see citing works
Vascular actions of insulin with implications for endothelial dysfunction
Potenza, M. A., Addabbo, F., & Montagnani, M. (2009) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00297.2009 · Cited by 159 · see citing works
Paclitaxel-Eluting Coronary Stents in Patients With Diabetes Mellitus
Kirtane, A. J., Ellis, S. G., Dawkins, K. D., Colombo, A., Grube, E., Popma, J. J., Fahy, M. P., Leon, M. B., Moses, J. W., Mehran, R., et al. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2007.10.035 · Cited by 107 · see citing works
Self-citationImpact of diabetes mellitus on long-term outcomes in the drug-eluting stent era
Iijima, R., Ndrepepa, G., Mehilli, J., et al. (2007) · American Heart Journal · doi:10.1016/j.ahj.2007.06.005 · Cited by 103 · see citing works
Kedhi, E., Généreux, P., Palmerini, T., McAndrew, T., Parise, H., Mehran, R., Dangas, G., & Stone, G. W. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.01.064 · Cited by 101 · see citing works
Self-citationIguchi, T., Hasegawa, T., Otsuka, K., Matsumoto, K., Yamazaki, T., Nishimura, S., Nakata, S., Ehara, S., Kataoka, T., Shimada, K., et al. (2013) · European Heart Journal - Cardiovascular Imaging · doi:10.1093/ehjci/jet158 · Cited by 91 · see citing works
Lee, T. T., Feinberg, L., Baim, D. S., et al. (2006) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2006.03.059 · Cited by 61 · see citing works
Maresta, A., Varani, E., Balducelli, M., et al. (2008) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2008.01.040 · Cited by 50 · see citing works
Tada, T., Kimura, T., Morimoto, T., Ono, K., Furukawa, Y., Nakagawa, Y., Nakashima, H., Ito, A., Siode, N., Namura, M., et al. (2011) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2010.12.013 · Cited by 50 · see citing works
Kandzari, D. E., Smits, P. C., Love, M. P., et al. (2017) · Circulation · doi:10.1161/circulationaha.117.028885 · Cited by 49 · see citing works
Self-citationChan, C., Zambahari, R., Kaul, U., et al. (2008) · Catheterization and Cardiovascular Interventions · doi:10.1002/ccd.21719 · Cited by 36 · see citing works
Pi, S.-H., Rhee, T., Lee, J. M., et al. (2018) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2018.02.034 · Cited by 33 · see citing works
Billinger, M., Räber, L., Hitz, S., Stefanini, G. G., Pilgrim, T., Stettler, C., Zanchin, T., Pulver, C., Pfäffli, N., Eberli, F. R., et al. (2012) · American Heart Journal · doi:10.1016/j.ahj.2012.02.014 · Cited by 30 · see citing works
Luca, G. D., Sauro, R., Capasso, M., et al. (2015) · Diabetes and Vascular Disease Research · doi:10.1177/1479164115592252 · Cited by 13 · see citing works
Drug-eluting stent outcomes in diabetes
Bernelli, C., Chan, J., & Chieffo, A. (2013) · Expert Review of Cardiovascular Therapy · doi:10.1586/14779072.2014.853615 · Cited by 12 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Abaci A, Oguzhan A, Kahraman S, et al. Ef- fect of diabetes mellitus on formation of coro- nary collateral vessels. Circulation 1999;99: 2239-42.
Cited by
Sorted by citations
Arnold, S. V., Bhatt, D. L., Barsness, G. W., Beatty, A. L., Deedwania, P. C., Inzucchi, S. E., Kosiborod, M., Leiter, L. A., Lipska, K. J., Newman, J. D., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000766 · Cited by 304 · see citing works
- Authors
- Konigstein, M., Ben-Yehuda, O., Smits, P. C., Love, M. P., Banai, S., Perlman, G. Y., Golomb, M., Ozan, M. O., Liu, M., Leon, M. B., Stone, G. W., & Kandzari, D. E.
- Affiliations
- Tel Aviv Sourasky Medical Center (IL)
- Maasstad Ziekenhuis (NL)
- St. Boniface Hospital (CA)
- Hadassah Medical Center (IL)
- Cardiovascular Research Foundation (US)
- NewYork–Presbyterian Hospital (US)
- Piedmont Atlanta Hospital (US)
- Corresponding author
- Kandzari, David E.
- ORCID
- Venue
- JACC: Cardiovascular Interventions
- Publisher
- Elsevier BV
- Published
- 2018-12
- Volume
- 11
- Issue
- 24
- Pages
- 2467-2476
- ISSN
- 1876-7605 (ISSN-L)
- 1936-8798
- OpenAlex
- W2903695177
- Cited by
- 66
- References
- 24
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 7 · 2023: 8 · 2022: 7 · 2021: 10 · 2020: 5 · 2019: 7 · 2018: 1
- FWCI
- 6.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- JACC: Cardiovascular Interventions (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Abbott Vascular
- Biotronik
- Medtronic
- Boston Scientific Corporation
- Topics
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- diabetes mellitus, percutaneous coronary intervention, drug-eluting stents, zotarolimus-eluting stent, target lesion failure, target lesion revascularization, in-stent restenosis, stent thrombosis, coronary artery disease
- MeSH terms
- Aged, Cardiovascular Agents, Coronary Artery Disease, Coronary Thrombosis, Diabetes Mellitus, Female, Humans, Male, Middle Aged, Myocardial Infarction, Prospective Studies, Prosthesis Design, Risk Factors, Time Factors, Prevalence, Single-Blind Method, Treatment Outcome, Sirolimus, Coronary Restenosis, Coronary Stenosis, Drug-Eluting Stents, Percutaneous Coronary Intervention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
