Copyright © 2015 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. Biolimus-Eluting StenT For de-novo coRonary artery dIsease in patiENts with Diabetes mellituS: the BESTFRIENDS multicentre registry Emanuele Meliga a,b,c,d,e,f,g , Alessandro Lupi a,b,c,d,e,f,g , Azeem Latib a,b,c,d,e,f,g , Andrea Gagnor a,b,c,d,e,f,g , Giacomo Boccuzzi a,b,c,d,e,f,g , Marco Alcantara a,b,c,d,e,f,g , Primiano Lombardi a,b,c,d,e,f,g , Alessandro Sticchi a,b,c,d,e,f,g , Tiziana C. Aranzulla a,b,c,d,e,f,g , Innocenzo Scrocca a,b,c,d,e,f,g , Ferdinando Varbella a,b,c,d,e,f,g , Mauro De Benedictis a,b,c,d,e,f,g , Antonio Colombo a,b,c,d,e,f,g and Maria Rosa Conte a,b,c,d,e,f,g Aims Coronary inflammation and healing influence outcomes of diabetic patients treated with Percutaneous coronary revascularization (PCI). Stents covered with biodegradable polymers (bp) may offer advantages over nonerodible polymer ones, because polymer reabsorption extinguish coronary inflammation and favours healing. Aim of our study was to assess the safety and efficacy of bp- biolimus-eluting stent (bp-BES) in a large series of consecutive diabetic patients. Methods From 2009 to 2013 we retrospectively enrolled consecutive diabetic patients treated with PCI and bp-BES implantation. Primary end points were target lesion revascularization (TLR) and stent thrombosis rates. Results Study cohort counted 747 patients. Multivessel disease was present in 48.2% with a mean stent/patient ratio of 1.860.78. During the hospital stay no stent thrombosis occurred. At 3-year follow-up we observed a 1.5% cumulative incidence of cardiac death, 1.1% of myocardial infarction and 6.3% of TLR. Stent thrombosis occurred in 1.1% of patients, all in the first 2 years of follow- up. Kaplan–Meier analysis showed a TLR-free survival at 1 and 3 years of 97.2 and 96.1%, respectively. Conclusion PCI with bp-BES seems to be well tolerated and effective in a large unselected population of diabetic patients. The good results observed were maintained at 3 years of follow-up. J Cardiovasc Med 2016, 16:000–000 Keywords: biolimus-eluting stent, diabetic patients, percutaneous coronary interventions a Mauriziano: Meliga, Aranzulla, Scrocca, De Benedictis, Conte, b Maggiore: Lupi, c San Raffaele: Latib, Sticchi, Colombo, d Degli Infermi: Gagnor, Varbella, e SG Bosco: Boccuzzi, f Centro Medico: Alcantara and g Cardinal Massaia: Lombardi Correspondence to Emanuele Meliga, MD, PhD, FESC, Interventional Cardiology Unit, Mauriziano Hospital, Largo Filippo Turati 62, Turin 10128, Italy. Tel: +39 011 508 50 38/39; fax: +39 011 508 24 37; e-mail: emeliga@gmail.com Received 21 January 2015 Revised 20 April 2015 Accepted 11 August 2015 Introduction Diabetes is associated with diffuse and rapidly progres- sive coronary artery disease (CAD) and has been shown to be an important predictor of death and myocardial infarc- tion (MI). 1–4 Percutaneous Coronary Intervention (PCI) revasculari- zation in patients with diabetes mellitus, even in the drug-eluting stent (DES) era, is associated with worse outcomes, in comparison with nondiabetic patients, both in terms of increased in-stent restenosis with need for repeat revascularizations 5,6 and stent thrombosis. 7,8 The adverse outcomes after PCI in patients with diabetes have been attributed to small calibre of the target vessels, severe and diffuse vascular inflammation, exuberant neointimal proliferation, prothrombotic state and clustering of cardiovascular risk factors. 5–8 In this peculiar clinical subset, biodegradable polymer-covered DES (bp-DES) may offer an advantage over durable polymer-covered DES (dp-DES) as they may improve coronary inflammation and healing with the gradual reabsorption of the proinflammatory polymer covering the metal stent struts of Bp-DES. 9,10 The more studied and employed bp-DES is the biolimus-eluting stent (BES). However, information about postmarketing effi- cacy and safety of this stent in an all-comers population of patients with diabetes are limited. 11,12 Thus, with the present study we aimed to evaluate the short-term and long-term clinical outcomes of bp-BES (Biomatrix, Biosensors International Ltd., Singapore and Original article 1558-2027 Copyright ß 2016 Wolters Kluwer Health, Inc. All rights reserved. DOI:10.2459/JCM.0000000000000335