The EVASTENT Matched-Cohort Registry investigated the frequency and causes of stent thrombosis in diabetic and nondiabetic patients after implantation of sirolimus-eluting stents.
The study population was a matched multicenter cohort registry of 1,731 patients undergoing revascularization exclusively with sirolimus stents.
The primary end point was a composite of stent thrombosis, cardiovascular death, and nonfatal myocardial infarction (major adverse cardiac events. Major events occurred in 78 patients (4.5%), cardiac death in 35 (2.1%), and stent thrombosis in 45 (2.6%): 30 definite, 23 subacute, and 22 late, including 9 at >6 months.
The 1-year stent thrombosis rate was 1.8 times higher in diabetic than in nondiabetic patients (3.2% vs. 1.7%; log rank p = 0.03), with diabetic patients with multiple-vessel disease experiencing the highest rate.
The other predictors were
- interruption of antithrombotic treatment,
- previous stroke,
- renal failure,
- lower ejection fraction,
- calcified lesion,
- length stented,
- insulin-requiring diabetes.
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