nach oben

Erschienen in:

29.01.2015 | Original Article

Assessment of vascular response after drug-eluting stents implantation in patients with diabetes mellitus: an optical coherence tomography sub-study of the J-DESsERT

verfasst von: Takashi Kubo, Takashi Akasaka, Takashi Tanimoto, Masamichi Takano, Yoshitane Seino, Kenya Nasu, Tomonori Itoh, Kyoichi Mizuno, Hiroyuki Okura, Toshiro Shinke, Jun-ichi Kotani, Shigenori Ito, Hiroyoshi Yokoi, Toshiya Muramatsu, Masato Nakamura, Shinsuke Nanto

Erschienen in: Heart and Vessels | Ausgabe 4/2016

Einloggen, um Zugang zu erhalten

Abstract

Even in the drug-eluting stent era, diabetes mellitus (DM) patients have high incidences of restenosis and repeat revascularization after percutaneous coronary intervention. The aim of this study was to compare vascular response after stent implantation between sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) by using optical coherence tomography (OCT) in DM patients as well as in non-DM patients. In the Japan-Drug Eluting Stents Evaluation; a Randomized Trial (J-DESsERT), the OCT sub-study enrolled 75 patients who underwent 8 months follow-up imaging after SES or PES implantation. Mean neointimal hyperplasia (NIH) thickness was significantly thinner in SES than PES in the DM group (77 ± 47 vs. 201 ± 114 μm, p < 0.001) and in the non-DM group (84 ± 37 vs. 212 ± 128 μm, p < 0.001). Unevenness of NIH thickness in longitudinal axis was significantly smaller in SES than PES in the DM group (348 ± 191 vs. 726 ± 385 μm, p < 0.001) and in the non-DM group (344 ± 174 vs. 679 ± 314 μm, p < 0.001). The percentage of uncovered struts was significantly greater in SES than PES in the DM group (24 ± 4 vs. 9 ± 14 %, p < 0.001) and in the non-DM group (16 ± 16 vs. 3 ± 4 %, p = 0.002). Compared with PES, SES showed more potent NIH inhibition in DM patients as well as in non-DM patients.

Kirtane AJ, Ellis SG, Dawkins KD, Colombo A, Grube E, Popma JJ, Fahy M, Leon MB, Moses JW, Mehran R, Stone GW (2008) Paclitaxel-eluting coronary stents in patients with diabetes mellitus: pooled analysis from 5 randomized trials. J Am Coll Cardiol 51:708–715CrossRefPubMed

Kastrati A, Mehilli J, Pache J, Kaiser C, Valgimigli M, Kelbaek H, Menichelli M, Sabaté M, Suttorp MJ, Baumgart D, Seyfarth M, Pfisterer ME, Schömig A (2007) Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents. N Engl J Med 356:1030–1039CrossRefPubMed

Sato T, Ono T, Morimoto Y, Kawai H, Fuke S, Ikeda T, Saito H (2012) Differences in clinical and angiographic outcomes with different drug-eluting stents in Japanese patients with and without diabetes mellitus. J Cardiol 60:361–366CrossRefPubMed

Tada T, Kimura T, Morimoto T, Ono K, Furukawa Y, Nakagawa Y, Nakashima H, Ito A, Siode N, Namura M, Inoue N, Nishikawa H, Nakao K, Mitsudo K, j-Cypher Registry Investigators (2011) Comparison of three-year clinical outcomes after sirolimus-eluting stent implantation among insulin-treated diabetic, non-insulin-treated diabetic, and non-diabetic patients from j-Cypher registry. Am J Cardiol 107:1155–1162CrossRefPubMed

Aronson D, Bloomgarden Z, Rayfield EJ (1996) Potential mechanisms promoting restenosis in diabetic patients. J Am Coll Cardiol 27:528–535CrossRefPubMed

Finn AV, Joner M, Nakazawa G, Kolodgie F, Newell J, John MC, Gold HK, Virmani R (2007) Pathological correlates of late drug-eluting stent thrombosis: strut coverage as a marker of endothelialization. Circulation 115:2435–2441CrossRefPubMed

Ikuta S, Kobuke K, Iwanaga Y, Nakauchi Y, Yamaji K, Miyazaki S (2014) Difference in neointimal coverage at chronic stage between bare metal stent and sirolimus-eluting stent evaluated at stent-strut level by optical coherence tomography. Heart Vessels 29:320–327CrossRefPubMed

Hashikata T, Tojo T, Namba S, Kitasato L, Hashimoto T, Kameda R, Shimohama T, Yamaoka-Tojo M, Ako J (2014) Neointimal coverage of zotarolimus-eluting stent at 1, 2, and 3 months’ follow-up: an optical coherence tomography study. Heart Vessels. doi:10.1007/s00380-014-0598-0 PubMed

Gamou T, Sakata K, Matsubara T, Yasuda T, Miwa K, Inoue M, Kanaya H, Konno T, Hayashi K, Kawashiri M, Yamagishi M (2014) Impact of thin-cap fibroatheroma on predicting deteriorated coronary flow during interventional procedures in acute as well as stable coronary syndromes: insights from optical coherence tomography analysis. Heart Vessels. doi:10.1007/s00380-014-0542-3

10.

Kubo T, Tanaka A, Ino Y, Kitabata H, Shiono Y, Akasaka T (2014) Assessment of coronary atherosclerosis using optical coherence tomography. J Atheroscler Thromb 21:895–903CrossRefPubMed

11.

Nakamura M, Muramatsu T, Yokoi H, Okada H, Ochiai M, Suwa S, Hozawa H, Kawai K, Awata M, Mukawa H, Fujita H, Shiode N, Asano R, Tsukamoto Y, Yamada T, Yasumura Y, Ohira H, Miyamoto A, Takashima H, Ogawa T, Matsuyama Y, Nanto S; On behalf of the J-DESsERT investigators (2014) Outcomes of the largest multi-center trial stratified by the presence of diabetes mellitus comparing sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in patients with coronary artery disease. The Japan drug-eluting stents evaluation: a randomized trial (J-DESsERT). Cardiovasc Interv Ther. doi: 10.1007/s12928-014-0279-z

12.

Kubo T, Akasaka T, Kozuma K, Kimura K, Fusazaki T, Okura H, Shinke T, Ino Y, Hasegawa T, Takashima H, Takamisawa I, Yamaguchi H, Igarashi K, Kadota K, Tanabe K, Nakagawa Y, Muramatsu T, Morino Y, Kimura T, Investigators NEXT (2014) Vascular response to drug-eluting stent with biodegradable vs. durable polymer. (2014) Optical coherence tomography substudy of the NEXT. Circ J 78:2408–2414CrossRefPubMed

13.

Kubo T, Tanaka A, Kitabata H, Ino Y, Tanimoto T, Akasaka T (2012) Application of Optical Coherence Tomography in Percutaneous Coronary Intervention. Circ J 76:2076–2083CrossRefPubMed

14.

Miyoshi N, Shite J, Shinke T, Otake H, Tanino Y, Ogasawara D, Sawada T, Kawamori H, Kato H, Yoshino N, Kozuki A, Hirata K (2010) Comparison by optical coherence tomography of paclitaxel-eluting stents with sirolimus-eluting stents implanted in one coronary artery in one procedure—6 month follow-up. Circ J 74:903–908CrossRefPubMed

15.

Kimura M, Mintz GS, Weissman NJ, Dawkins KD, Grube E, Ellis SG, Cannon LA, Masud Z, Mandinov L, Baim D, Stone GW (2008) Meta-analysis of the effects of paclitaxel-eluting stents versus bare metal stents on volumetric intravascular ultrasound in patients with versus without diabetes mellitus. Am J Cardiol 101:1263–1268CrossRefPubMed

16.

Sakata K, Waseda K, Kume T, Otake H, Nakatani D, Yock PG, Fitzgerald PJ, Honda Y (2012) Impact of diabetes mellitus on vessel response in the drug-eluting stent era: pooled volumetric intravascular ultrasound analyses. Circ Cardiovasc Interv 5:763–771CrossRefPubMed

17.

Dibra A, Kastrati A, Mehilli J, Pache J, Schuhlen H, von Beckerath N, Ulm K, Wessely R, Dirschinger J, Schomig A (2005) Paclitaxel-eluting or sirolimus-eluting stents to prevent restenosis in diabetic patients. N Engl J Med 353:663–670CrossRefPubMed

18.

Morice MC, Colombo A, Meier B, Serruys P, Tamburino C, Guagliumi G, Sousa E, Stoll HP (2006) Sirolimus- vs paclitaxel-eluting stents in de novo coronary artery lesions: the REALITY trials: a randomized controlled trial. JAMA 295:895–904CrossRefPubMed

19.

Mahmud E, Bromberg-Marin G, Palakodeti V, Ang L, Creanga D, Demaria AN (2008) Clinical efficacy of drug-eluting stents in diabetic patients: a meta-analysis. J Am Coll Cardiol 51:2385–2395CrossRefPubMed

20.

Goy JJ, Stauffer JC, Sieganthaler M, Benoit A, Seydoux C (2005) A prospective randomized comparison between paclitaxel and sirolimus stents in the real world of interventional cardiology: the TAXi trial. J Am Coll Cardiol 45:308–311CrossRefPubMed

21.

Jensen LO, Maeng M, Thayssen P, Christiansen EH, Hansen KN, Galloe A (2008) Neointimal hyperplasia after sirolimus-eluting and paclitaxel-eluting stent implantation in diabetic patients: the randomized diabetes and drug-eluting stent (DiabeDES) intravascular ultrasound trial. Eur Heart J 29:2733–2741CrossRefPubMed

22.

Kim JS, Kim JS, Kim TH, Fan C, Lee JM, Kim W, Ko YG, Choi D, Hong MK, Jang Y (2010) Comparison of neointimal coverage of sirolimus-eluting stents and paclitaxel-eluting stents using optical coherence tomography at 9 months after implantation. Circ J 74:320–326CrossRefPubMed

23.

Kubo T, Akasaka T, Shite J, Suzuki T, Uemura S, Yu B, Kozuma K, Kitabata H, Shinke T, Habara M, Saito Y, Hou J, Suzuki N, Zhang S (2013) Optical coherence tomography compared to intravascular ultrasound in coronary lesion assessment study: OPUS-CLASS study. JACC Cardiovasc Imaging 6:1095–1104CrossRefPubMed

24.

Guagliumi G, Sirbu V, Musumeci G, Gerber R, Biondi-Zoccai G, Ikejima H, Ladich E, Lortkipanidze N, Matiashvili A, Valsecchi O, Virmani R, Stone GW (2012) Examination of the in vivo mechanisms of late drug-eluting stent thrombosis: findings from optical coherence tomography and intravascular ultrasound imaging. JACC Cardiovasc Interv 5:12–20CrossRefPubMed

Titel: Assessment of vascular response after drug-eluting stents implantation in patients with diabetes mellitus: an optical coherence tomography sub-study of the J-DESsERT
verfasst von: Takashi Kubo
Takashi Akasaka
Takashi Tanimoto
Masamichi Takano
Yoshitane Seino
Kenya Nasu
Tomonori Itoh
Kyoichi Mizuno
Hiroyuki Okura
Toshiro Shinke
Jun-ichi Kotani
Shigenori Ito
Hiroyoshi Yokoi
Toshiya Muramatsu
Masato Nakamura
Shinsuke Nanto
Publikationsdatum: 29.01.2015
Verlag: Springer Japan
Erschienen in: Heart and Vessels / Ausgabe 4/2016
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-015-0636-6

Neu im Fachgebiet Kardiologie

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2016

Repression of wall shear stress inside cerebral aneurysm at bifurcation of anterior cerebral artery by stents

Impact of preoperative regular physical activity on postoperative course after open abdominal aortic aneurysm surgery

Additive clinical value of serum brain-derived neurotrophic factor for prediction of chronic heart failure outcome

Comparison of pulse wave velocity assessed by three different techniques: Arteriograph, Complior, and Echo-tracking

Change of luminal diameter of skeletonized and non-skeletonized radial artery graft at early and late postoperative period