Heart Stents Have Better Outcome than Balloon Angioplasty in Diabetics

In diabetic patients, coronary stent implantation results in a better six-month angiographic outcome and four-year clinical events compared with standard balloon angioplasty.

This was the finding of a study by Dr. Eric Belle and colleagues. Dr Belle is based at the Centre Hospitalier Régional, Lille, France.

The investigators matched 314 diabetic patients treated with either coronary stenting or standard balloon angioplasty from a population of consecutive diabetic patients. Patients in the two groups were matched for gender, anti-diabetic regimen, stenosis location, reference diameter, and minimal luminal diameter. One lesion per patient was considered for matching.

It was found that the rates of stenosis and occlusion were much lower in the stent group than in the balloon angioplasty group. Restenosis was 27 percent in the stent group and 62 percent in the balloon angioplasty group (P=<0.0001). Occlusion was four per cent in the stent group and 13 percent in the balloon angioplasty group (P=<0.005). There was also a significant decrease in ejection fraction at six months in the balloon angioplasty group, while no decrease was seen in the stent group. Said Dr Belle, “Subgroup analysis demonstrated that angiographic benefit was consistent among the subgroups. At four years, the combined clinical end point of cardiac death and non-fatal myocardial infarction was lower in the stent group, as was the need for repeat revascularization.” The combined clinical endpoint of cardiac death and non-fatal myocardial infarction was 14.8 percent in the stent group and 26 percent in the balloon angioplasty group (P=0.02). The need for repeat revascularization in the stent group was 35.4 percent and it was 52.1 percent in the balloon angioplasty group (P=0.001). Journal of the American College of Cardiology 2002;40(3):410-417.