Coronary stenting in diabetic patients: Results from the ROSETTA registry

Objective Diabetes mellitus is associated with high rates of restenosis and adverse outcomes after percutaneous transluminal coronary angioplasty (PTC A). It is unclear whether coronary stenting reduces adverse events in diabe tic patients after PTCA. Our purpose was to determine whether coronary sten ting improves clinical event rates in diabetic patients after PTCA. Methods The Routine Versus Selective Exercise Treadmill Testing After Angio plasty (ROSETTA) registry was a prospective multicenter observational study examining functional testing and adverse outcomes after successful PTCA. Results: Among the 791 patients enrolled, 180 were diabetic. A total of 90 diabetics received stents while the remaining 90 patients did not. Baseline clinical characteristics were similar between the 2 groups of patients. Ho wever, patients with stents were more likely to have complex lesions, where as those without stents were more likely to undergo atherectomy and cave gr eater residual coronary stenosis. At 6-month follow-up, the composite end: point defined as cardiac death, unstable angina, myocardial infarction, nee d for repeat PTCA, or coronary artery bypass graft surgery (CABG) occurred in 25.0% of stented and 22.2% of nonstented diabetic patients (P not signif icant [NS]). A multivariate logistic regression analysis showed that corona ry stenting was not associated with a reduced incidence of the composite en d point among diabetic patients (odds ratio 0.97, 95% Cl 0.46-2.05, P NS). Conclusion Coronary stenting does not improve clinical event rates in diabe tic patients after PTCA.