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Despite the better clinical performance of second-generation drug-eluting stents (DES) when compared to first-generation DES in controlled trials, mainly due to reduction in thrombosis rate, it remains unclear whether this benefit extends to diabetic patients treated in the daily practice. We sought to compare the clinical outcomes of unselected diabetic patients treated with either sirolimus eluting stents - SES (first-generation DES) or everolimus-eluting stents - EES (second-generation DES).

Stents farmacológicos (SF) de segunda geração demonstraram melhor desempenho clínico que os de primeira geração, sobretudo pela redução nas taxas de trombose, mas ainda não está claro se esse benefício se estende a diabéticos da prática diária. Objetivamos comparar o desempenho de pacientes diabéticos não selecionados tratados com SF eluidores de sirolimus (SES; primeira geração) vs. SF eluidores de everolimus (SEE; segunda geração).

Identification of hybernating myocardium (HM) by magnetic resonance imaging (MRI), is controversial. Trying to optimize MRI results we studied 45 pts with coronary artery disease (CAD) and depressed left ventricular wall motion (LVWM) and ejection fraction (LVEF) at baseline angiogram (ANGlO). MRI before and after a low doses infusion of dobutamine (00,5 mcglkg/min). MRI defined LVWM and LVEF correlated with those of ANGlO (r=0.767 and r=0.843, respectively). After DO injection T1 signal increased in 27 (65±15 vs. 98±9, p=0.03) pts whereas 18 pts had non significant changes (58±12 vs. 52±12, P=NS). All pts underwent coronary bypass surgery and repeated MRI before hospital discharge. LVEF (0.32 vs 0.45, p=0.03) and LVWM (-2.6±0.8 vs 0.8±0.4 P=0.04) improved in the 27 pts with T1 changes. None of the others improved LVEF (0.34 vs 0.36, P=NS) or LVWM (-2.4±1.2 vs. -1.8±0.7, P=NS). Conclusion; DO-MRI seems to be an effective manner to identify HM in pts with chronic CAD and depressed LV contractility.