Outcomes of Contemporary DES in Patients with Diabetes: Do They Render Freedom Obsolete?

Despite our high hopes for new-generation drug-eluting stents (DES), patients with diabetes still have a different prognosis, both clinical and angiographic, compared with non-diabetic patients. Authors sought to investigate the impact of diabetes on patients who underwent drug-eluting stent implantation in the BIONICS (BioNIR Ridaforolimus Eluting Coronary Stent System in Coronary Stenosis) trial.   This<a href="https://solaci.org/en/2019/01/28/outcomes-of-contemporary-des-in-patients-with-diabetes-do-they-render-freedom-obsolete/" title="Read more" >...</a>

Coronary Disease in Diabetes: Diabetic Patients Have Much Greater Plaque Progression

Patients with diabetes mellitus experience significantly greater plaque progression, particularly regarding adverse plaque. Male sex and baseline plaque volume >75% were identified as independent risk factors for plaque progression; the latter actually tripled the risk. This study with tomographic follow-up sought to determine the rate and extent of plaque progression, changes in plaque features, and<a href="https://solaci.org/en/2018/12/04/coronary-disease-in-diabetes-diabetic-patients-have-much-greater-plaque-progression/" title="Read more" >...</a>

Silent Diabetes Is the New Stealthy Enemy

One in three “nondiabetic” patients who undergo angioplasty with current drug-eluting stents have an altered glucose metabolism, which is associated with a 4-fold higher risk of events, according to a study that will be published soon in JACC Intv. One in three patients is definitely one patient too many, and four times higher is definitely<a href="https://solaci.org/en/2018/03/20/silent-diabetes-is-the-new-stealthy-enemy/" title="Read more" >...</a>

Does a Combination of Diabetes and Acute Coronary Syndrome Change the Revascularization Strategy?

The results of the FREEDOM (Future Revascularization Evaluation in Patients With Diabetes Mellitus: Optimal Management of Multi-vessel Disease) trial have shown a lower rate of events in patients with diabetes and stable multivessel disease who were randomized to undergo myocardial revascularization surgery, compared to those who underwent angioplasty. Surgery even showed a mortality reduction that<a href="https://solaci.org/en/2018/01/22/does-a-combination-of-diabetes-and-acute-coronary-syndrome-change-the-revascularization-strategy/" title="Read more" >...</a>

Introducing the number one enemy of PCI: diabetes

About 25% of patients with multivessel disease undergoing myocardial revascularization surgery or PCI have diabetes.   In this subgroup, the benefit of surgery in terms of mortality has long been shown: in the BARI study (Bypass Angioplasty Revascularization Investigation) patients undergoing PCI had close to double the mortality rate at 5 years compared to those<a href="https://solaci.org/en/2017/09/22/introducing-the-number-one-enemy-of-pci-diabetes/" title="Read more" >...</a>

Sorpresivo hallazgo en diabetes y permeabilidad de los bypass

Striking Finding on Diabetes and Bypass Graft Patency

The higher rate of restenosis in the diabetic population is historic and has been reproduced in all studies and with all kinds of stents, but it was only after the FREEDOM trial when we found out about the higher infarction rate with PCI compared to surgery. This is why 50% of patients undergoing CABG are diabetic. Apart from the above<a href="https://solaci.org/en/2017/09/01/striking-finding-on-diabetes-and-bypass-graft-patency/" title="Read more" >...</a>

EVOLVE II: Diabetes Substudy: Results at 3 Years after the SYNERGY Stent in Diabetics

Courtesy of SBHCI Diabetic patients have worse evolution after coronary PCI. Drug eluting stents with bioresorbable polymers were designed to facilitate arterial healing, and reduce inflammation and late and very late thrombosis risk.   This sub-study of diabetic EVOLVE II patients presents the 3 year outcomes of the SYNERGY stent.   The EVOLVE II included<a href="https://solaci.org/en/2017/05/25/evolve-ii-diabetes-substudy-results-at-3-years-after-the-synergy-stent-in-diabetics/" title="Read more" >...</a>

Diabetes has higher impact on DES outcomes than disease complexity

Original Title: Impact of diabetic status on outcomes after revascularization with drug-eluting stents in relation to coronary artery disease complexity. Reference: Koskinas KC et al. Circ Cardiovasc Intv. 2016; Epub ahead of print   Diabetic patients ongoing PCI with drug eluting stents (DES) are at higher risk of repeat revascularization than non-diabetic patients. According to this<a href="https://solaci.org/en/2016/02/22/diabetes-has-higher-impact-on-des-outcomes-than-disease-complexity/" title="Read more" >...</a>