Diabetes Mellitus and Prevention of Late Myocardial Infarction After Coronary Stenting in the Randomized Dual Antiplatelet Therapy Study

• DOI: 10.1161/circulationaha.115.016783
• Publication Date: 2016-03-19T04:15:23Z
• Authors: Ian T. Meredith; Jean-François Tan...; Dean J. Kereiakes; Donald E. Cutlip; Robert W. Yeh; Kirk N. Garratt; David P. Lee; P. Gabriel Steg; W. Douglas Weaver; David R. Holmes; Ralph G. Brindis; Jaroslaw Trebacz; Joseph M. Massaro; Wen-Hua Hsieh; Laura Mauri
• Keywords: Thienopyridine; Stroke

Patients with diabetes mellitus (DM) are at high risk for recurrent ischemic events after coronary stenting. We assessed the effects of continued thienopyridine among patients DM participating in Dual Antiplatelet Therapy (DAPT) Study as a prespecified analysis.After stent placement and 12 months treatment open-label plus aspirin, 11 648 free or bleeding who were medication compliant randomly assigned to placebo, addition 18 more months. After randomization, (n=3391), comparison without (n=8257), had increased composite outcome death, myocardial infarction (MI), stroke (6.8% versus 4.3%, P<0.001), death (2.5% 1.4%, MI (4.2% 2.6%, P<0.001). Among DM, rates thrombosis 0.5% 1.1%, P=0.06, 3.5% 4.8%, P=0.058; 0.4% P<0.001 (stent thrombosis, P interaction=0.21) 1.6% 3.6%, (MI, interaction=0.02). Bleeding was similar (interaction P=0.61).In beyond 1 year stenting is associated reduced MI, although this benefit attenuated DM.URL: http://www.clinicaltrials.gov. Unique identifier: NCT00977938.