Abstract
Diabetes mellitus is a strong predictor of in-stent restenosis after bare-metal stent placement because of exaggerated intimal hyperplasia (IH). In this study, serial intravascular ultrasound was used to evaluate the effects of polymer-based, paclitaxel-eluting stents (PES) on in-stent neointima formation in patients with and without diabetes. A volumetric IVUS meta-analysis of 956 patients randomized to PES or bare-metal stents in the TAXUS IV (n=268), TAXUS V (n=509), and TAXUS VI (n=179) trials was performed. Diabetes was present in 273 of the 956 patients (28.6%). Stent, luminal, and IH areas were measured every millimeter within the stent, and volumes, percentage IH (%IH), and neointima-free stent length were calculated. Patients with diabetes treated with bare-metal stents had greater IH volumes (78.9 vs 61.2 mm3, p=0.0095) and %IH (34.9% vs 30.1%, p=0.0186) compared with those without diabetes. However, patients with diabetes treated with PES had similar median IH volume (22.8 vs 16.3 mm3, p=0.35) and median %IH (9.1% vs 9.2%, p=0.27) compared with those without diabetes and significantly less IH volume and %IH than after bare-metal stent implantation (p<0.0001 for the 2 comparisons). In conclusion, serial volumetric IVU...Continue Reading
References
Mar 1, 1979·Diabetes Care·W B Kannel, D L McGee
Apr 1, 1987·Diabetes/metabolism Reviews·K PyöräläM Uusitupa
Feb 15, 1995·Circulation·B SteinS B King
Mar 1, 1993·Annals of Internal Medicine·J P CarrozzaD S Baim
Feb 1, 1993·Diabetes Care·J StamlerD Wentworth
Jul 15, 1997·Circulation·D I AxelK R Karsch
Apr 9, 1999·The Journal of Clinical Investigation·A VirkamäkiC R Kahn
Mar 10, 2001·Circulation·E Van BelleM E Bertrand
Apr 6, 2001·Diabetes Care·D Le Roith, Y Zick
Dec 31, 2002·Journal of the American College of Cardiology·Donald E CutlipRichard E Kuntz
Aug 6, 2003·Circulation·Antonio ColomboUNKNOWN TAXUS II Study Group
Feb 6, 2004·Circulation·Nick E J WestPatrick W Serruys
Feb 11, 2004·Circulation·Patrick W SerruysUNKNOWN TAXUS II Study Group
Dec 28, 2004·The American Journal of Cardiology·Gary S MintzNeil J Weissman
Oct 29, 2005·The American Journal of Cardiology·Ryota SakuraiUNKNOWN SIRIUS Trial Investigators
Nov 9, 2005·The American Journal of Cardiology·Paolo OrtolaniAntonio Marzocchi
Nov 16, 2005·Circulation·Keith D DawkinsUNKNOWN TAXUS VI Investigators
May 2, 2006·Advanced Drug Delivery Reviews·Kalpana R KamathKathleen M Miller
Citations
Oct 23, 2013·Interactive Cardiovascular and Thoracic Surgery·Nicholas D GollopMarcus D Flather
Jun 23, 2009·The American Journal of Cardiology·John M LasalaKeith D Dawkins
Apr 8, 2015·Journal of cardiology·Ken KozumaTakaaki Isshiki
Sep 29, 2009·American Heart Journal·Eugenia NikolskyGregg W Stone
Jan 19, 2010·Journal of the American College of Cardiology·Adrian P BanningPatrick W Serruys
May 26, 2009·JACC. Cardiovascular Interventions·Ehtisham MahmudDonald S Baim
May 26, 2009·JACC. Cardiovascular Interventions·Corrado TamburinoFrancesco Prati
Jan 30, 2015·Heart and Vessels·Takashi KuboShinsuke Nanto
Nov 15, 2012·Circulation. Cardiovascular Interventions·Kenji SakataYasuhiro Honda
Mar 23, 2010·Coronary Artery Disease·Run DuWei Feng Shen