Outcomes with drug-eluting stents in diabetic patients

The relationship between diabetes mellitus and coronary artery disease is well established. The percentage of patients participating in clinical trials of percutaneous coronary intervention who have diabetes is quickly rising. Diabetic patients have a worse prognosis than nondiabetic patients, with generally greater rates of death, myocardial infarction and need for target lesion and vessel revascularization. Stenting has improved the outcome of diabetic patients receiving percutaneous coronary intervention. Compared with bare-metal stents, the use of drug-eluting stents in diabetic patients has resulted in a significant reduction in late lumen loss, binary restenosis, and clinically driven target vessel revascularization. The safety and efficacy of drug-eluting stents in diabetic patients is now well established; they are the preferred option in this subgroup in the absence of contraindications. New stent designs, polymers and drugs are resulting in better outcomes overall, but more research is required to define their relative efficacy relative to other treatment options in diabetics.