Original paper
Analysis of the rate of restenosis in patients with acute coronary syndrome without ST elevation and concomitant diabetes mellitus type 2 according to the kind of stent

Background : Acute coronary syndrome without ST segment elevation (NSTEMI) in patients with diabetes mellitus (DM) has poor prognosis and percutaneous coronary intervention (PCI) is the best treatment strategy. However, there are no clear guidelines concerning the choice of optimal invasive treatment strategy.

Aim: To evaluate the restenosis rate in patients with NSTEMI and DM depending on the kind of implanted stent.

Material and methods: The study group comprised 984 NSTEMI patients hospitalized in the 2nd Department of Cardiology. 352 patients received a bare metal stent (BMS), while 632 pts received a drug-eluting stent (DES) – 238 pts a paclitaxel-eluting stent (PES) and 394 a sirolimus-eluting stent (SES). There were no statistically significant differences concerning age of the groups.

Results: After 1-year follow-up there were no significant mortality differences – 7.9% in the BMS group, 8.8% in the PES group and 8.1% in the SES group. There were 6 in-hospital deaths, one in the BMS and PES groups and 4 in the SES group. After 1-year follow-up there were significant restenosis rate differences: 8.24% in the BMS group, 8.4% in the PES group and 6.34% in the SES group (p = 0.003). Stent thrombosis was a rare complication and occurred in 10 patients without differences in stent groups. The predictors of restenosis revealed by univariate logistic regression analysis included female gender, lipid disturbances (p < 0.001), past myocardial infarction (p < 0.001) and peripheral arterial disease (p < 0.001).

Conclusions: Percutaneous coronary angioplasty in patients with NSTEMI and coexisting DM is effective and safe. Implantation of sirolimus-eluting stents gives the best long-term results expressed as the lowest restenosis rate.