A study designed and led by the Bellvitge University Hospital and IDIBELL has shown the greater suitability of a new type of stent to treat coronary disease (heart attack and angina pectoris) in diabetic people.
The results were presented on November 5 by Dr. Rafael Romaguera, from the Cardiology Service of the Bellvitge University Hospital and from the IDIBELL Research Group on Cardiovascular Diseases, during the Transcatheter Cardiovascular Therapeutics 2021 congress. Simultaneously, the study has been published in the European Heart Journal, the cardiovascular journal with the highest impact factor worldwide.
There are 500 million people in the world with diabetes. This disease represents a relevant cardiovascular risk factor, since it causes glucose to accumulate in the blood and progressively damage blood vessels, accelerating arteriosclerosis. In that regard, when they need to be treated for a coronary problem with catheterization and stenting, the results are clearly worse than those obtained in the non-diabetic population.
As Dr. Romaguera explains: “The results of the drug-eluting stents that had been developed so far were very good in non-diabetic patients but clearly needed improvement in diabetic patients; for that reason, it was important to test new devices and strategies in this group of high-risk patients.”
In 2017, a first study by Bellvitge researchers based on angiographic control (RESERVOIR study), already highlighted the efficacy of a new stent that releases a combination of drugs called amphilimus, and, unlike others, does so without using a polymer (element that helps to dose the drug but that, at the same time, could cause inflammatory reactions). To confirm these promising results, the current investigation (SUGAR study) to follow up the long-term clinical outcomes of the new device was designed.
Carried out with the support of the Spanish Society of Cardiology, the SUGAR study randomized a total of 1,175 patients from 23 Spanish hospitals. One group of patients received the new amphilimus-eluting stent, and the rest, a commonly used drug-eluting stent that releases the drug zotarolimus and a polymer.
After one year of follow-up, it has been found that the patients who have been treated with the new stent have had 35% fewer serious problems (mortality, new heart attack, or new episode of arterial constipation in the area treated with the stent).
Romaguera highlights that these results represent «the first improvement that appears in more than ten years in the treatment of diabetic patients with coronary catheterization». Likewise, he considers that the results are consistent enough to imply immediate effects in clinical practice, so this new device should be considered the reference stent for the treatment of diabetic patients.