Drug-eluting stents for diabetes mellitus: a rush to judgment?

J Am Coll Cardiol. 2005 Feb 15;45(4):479-83. doi: 10.1016/j.jacc.2004.10.060.


The two pivotal U.S. trials of drug-eluting stents do not establish the principle that these stents are superior to thin-strut bare-metal stents for preventing repeat revascularization in patients with diabetes. Neither study was adequately powered to make this determination. Moreover, both studies used thick-strut stents known to have high restenosis rates as controls. Low angiographic follow-up underestimates the true target lesion revascularization rate in the Polymer-Based Paclitaxel-Eluting Stent in Patients with Coronary Artery Disease (TAXUS-IV) trial because of the high incidence of silent ischemia in patients with diabetes. Optimal therapy for diabetic coronary disease should include a comprehensive approach directed toward metabolic normalization in addition to local stent-based therapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Clinical Trials as Topic
  • Coronary Angiography
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / drug therapy*
  • Coronary Restenosis / diagnostic imaging
  • Coronary Restenosis / prevention & control
  • Diabetic Angiopathies / diagnostic imaging
  • Diabetic Angiopathies / drug therapy*
  • Drug Delivery Systems*
  • Humans
  • Paclitaxel / administration & dosage*
  • Sirolimus / administration & dosage*
  • Stents*


  • Paclitaxel
  • Sirolimus