Upendra Kaul
What was your rationale for this study and what was known before?
The choice of a drug-eluting stent in diabetics has been the subject of debate for a decade. Based on a large meta-analysis, paclitaxeleluting stents have traditionally been given an equivalent status to everolimus-eluting stents (possibly even favoured over them) in insulin-dependent diabetics. This position was challenged on the basis of a patient-based meta-analysis. In the absence of an adequately powered study, a definitive answer was not possible.
What is unique about this study in your country?
This Indian study is the largest international study to compare a paclitaxel-eluting stent (PES) versus an everolimus-eluting stent (EES) in a diabetic population1. In total, 1,830 patients with diabetes mellitus were included using a non-inferiority trial design. They received either a PES (TAXUS Element™; Boston Scientific, Marlborough, MA, USA) or an EES (XIENCE PRIME; Abbott Vascular, Santa Clara, CA, USA). The primary endpoint was target vessel failure defined as a composite of cardiac death, target vessel myocardial infarction, or ischaemia-driven target vessel revascularisation at one-year follow-up.