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Randomized prospective hEad-to-head COMparison of everoliMus-Eluting steNt versus paclitaxel-eluting stent in Patients with Diabetes mellitus: RECOMMEND trial
가톨릭의과대학 순환기 내과학 교실¹
고윤석¹, 허성호¹, 이종민¹, 서석민¹, 추은호¹, 박만원¹, 윤성규¹, 최윤석¹ , 박훈준¹ , 박철수¹ , 김범준¹ ,장기육¹ ,정욱성 ¹, 승기배¹ ,
Backgrounds: It has been showed that everolimus-eluting stent (EES) is superior to paclitaxel-eluting stent (PES) in terms of major adverse cardiac event (MACE) in some trials. However, in diabetic patients, there were little data which stent is more effective and safe between EES and PES. Methods: This prospective, multicenter, randomized trial compared EES (n=142) and PES (n=142) for diabetic patients. The primary end point was in-stent late luminal loss (LLL) at 9 months angiographic follow up.Results: The baseline clinical and angiographic characteristics were similar between two groups. Angiographic follow up was achieved 54 % (n=77) in PES and 56 % (n=80) in EES. Nine month in-stent and in-segment LLL and percent diameter stenosis was lower in EES group than PES group (0.233 mm vs. 0.384, p=0.05, 0.1633 mm vs. 0.2291 mm, p=0.07, 10.8 % vs. 22.8 %, p=0.006, respectively). There were no differences in death, cardiac death, MI, composite cardiac death, MI, target lesion revascularization (TLR) between two groups. However, TLR and target vessel revascularization (TVR) including TLR was lower in EES group in trend (Table). Conclusions: EES may be superior in reducing angiographic restenosis and TVR in patients performed elective PCI with diabetes compared with PES. We will announce more follow up angiographic data on October.

Table. Major adverse cardiac events according to stent type

Variables

PES

EES

P-value

All-cause death (%)

6 (4 %)

5 (3.1 %)

1

Cardiac death (%)

1 (0.8 %)

3 (2%)

0.62

MI (%)

2 (1.6 %)

1 (0.4 %)

1

Target lesion revascularization (TLR) (%)

16 (11.1 %)

8 (5.5 %)

0.06

Target vessel revascularization (TVR) (%)

18 (12.6 %)

10 (6.7 %)

0.07

Composite cardiac death, MI (%)

3 (2.4 %)

3 (2.4 %)

1

Composite cardiac death, MI, TLR (%)

18 (12.6 %)

11 (7.9 %)

0.133

Stent thrombosis (%)

2 (1.2 %)

1 (0.8 %)

1

 



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