Comparison of Coronary Restenosis Rates in Matched Patients With Versus Without Diabetes Mellitus

Radke, Peter W.; Friese, K.; Buhr, Andrea; Nagel, Bernard; Harland, Lars-Christian; Kaiser, Axel; Remmel, Marko; Hanrath, Peter; Schunkert, Heribert; Hoffmann, Rainer

doi:10.1016/j.amjcard.2006.06.015

Cited by 19 publications

(9 citation statements)

References 23 publications

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“…This finding is agreement with clinical restenosis that is characterized by exaggerated neointima formation in patients with diabetes. [47][48][49] In addition, the extent of macrophage content in the neointimal lesions from the WD-fed apoE Ϫ/Ϫ mouse model was close to that found in human restenotic lesions. Moreno et al 50 reported that macrophage-rich areas were ϳ20% in restenotic lesions from patients with restenosis.…”

Section: Wd-fed Apoementioning

confidence: 72%

CD40 Ligand Promotes Mac-1 Expression, Leukocyte Recruitment, and Neointima Formation after Vascular Injury

Sanders

Bevard

et al. 2008

The American Journal of Pathology

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High levels of circulating soluble CD40 ligand (sCD40L) are frequently found in patients with hypercholesterolemia, diabetes, ischemic stroke, or acute coronary syndromes, predicting an increased rate of atherosclerotic plaque rupture and restenosis after coronary/carotid interventions. Clinical restenosis is characterized in part by exaggerated neointima formation, but the underlying mechanism remains incompletely understood. This study investigated the role of elevated sCD40L in neointima formation in response to vascular injury in an atherogenic animal model and explored the molecular mechanisms involved. apoE ؊/؊ mice fed a Western diet developed severe hypercholesterolemia, significant hyperglycemia, and high levels of plasma sCD40L. Neointima formation after carotid denudation injury was exaggerated in the apoE ؊/؊ mice. In vivo, blocking CD40L with anti-CD40L monoclonal antibody attenuated the early accumulation of Ly-6G؉ neutrophils and Gr-1 ؉ monocytes (at 3 days) and the late accumulation of Mac-2 ؉ macrophages (at 28 days) in the denudated arteries; it also reduced the exaggerated neointima formation at 28 days. In vitro, recombinant CD40L stimulated platelet P-selectin and neutrophil Mac-1 expression and platelet-neutrophil co-aggregation and adhesive interaction. These effects were abrogated by anti-CD40L or anti-Mac-1 monoclonal antibody. Moreover, recombinant CD40L stimulated neutrophil oxidative burst and release of matrix metalloproteinase-9 in vitro. We conclude that elevated sCD40L promotes platelet-leukocyte activation and recruitment and neointima formation after arterial injury, potentially through enhancement of platelet P-selectin and leukocyte Mac-1 expression and oxidative activity. (Am J

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Section: Wd-fed Apoementioning

confidence: 72%

CD40 Ligand Promotes Mac-1 Expression, Leukocyte Recruitment, and Neointima Formation after Vascular Injury

Sanders

Bevard

et al. 2008

The American Journal of Pathology

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“…The presence of DM is associated with higher neointimal hyperplasia, restenosis, and unfavorable clinical outcomes in the era of DES (17,18). Recently, several randomized trials and registries showed inconsistent results regarding the superiority of SES over PES in diabetic patients (6 -10).…”

Section: Discussionmentioning

confidence: 97%

A Randomized Comparison of Sirolimus- Versus Paclitaxel-Eluting Stent Implantation in Patients With Diabetes Mellitus

Lee

Park

Kim

et al. 2008

Journal of the American College of Cardiology

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“…Although several studies reported that DM was an independent risk factor of clinical outcomes after coronary stenting [7]–[10], some other studies failed to identify the association in patients after DES implantation [11], [12]. Additionally, several meta-analyses [13], [14] and clinical trials [15], [16] showed inconsistent results which might be caused by 1) uncontrolled or incomplete control for confounding 2) relatively small sample size.…”

Section: Introductionmentioning

confidence: 99%

The Association of Diabetes Mellitus with Clinical Outcomes after Coronary Stenting: A Meta-Analysis

et al. 2013

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BackgroundPrevious studies have shown inconsistent results on the association between diabetes mellitus (DM) and some clinical outcomes. We conducted a meta-analysis of observational studies to assess effect of DM on clinical outcomes after coronary stenting.MethodsWe searched for studies without language restriction in PubMed, Embase and Cochrane library prior to 2012. The clinical outcomes including in-stent restenosis (ISR), major adverse cardiac events (MACE), stent thrombosis (ST), target lesion revascularization (TLR) and target vessel revascularization (TVR). Adjusted odds ratio (OR), and the corresponding 95% confidence interval (95% CI) was summarized.Results55 studies involving 128,084 total patients (38,416 DM patients and 89,668 controls) were eligible for our analysis. Overall, there were significant associations between DM and ISR (OR = 1.70, 95% CI: 1.53–1.89, I2 = 0.0%), MACE (OR = 1.54, 95% CI: 1.36–1.73, I2 = 29.0%), ST (OR = 2.01, 95% CI: 1.36–2.97, I2 = 47.7%), TLR (OR = 1.46, 95% CI: 1.26–1.68, I2 = 43.3%) as well as TVR (OR = 1.33, 95% CI: 1.17–1.51, I2 = 48.3). Subgroup analysis showed that the associations were similar between BMS and DES implantation. Moreover, there was no significant association in the ST subgroup after 1–3 years follow-up.ConclusionsOur meta-analysis suggests that after coronary stent implantation, DM is associated with ISR, MACE, ST, TLR and TVR. DM appears to be a vital risk factor of these clinical outcomes.

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Comparison of Coronary Restenosis Rates in Matched Patients With Versus Without Diabetes Mellitus

Cited by 19 publications

References 23 publications

CD40 Ligand Promotes Mac-1 Expression, Leukocyte Recruitment, and Neointima Formation after Vascular Injury

CD40 Ligand Promotes Mac-1 Expression, Leukocyte Recruitment, and Neointima Formation after Vascular Injury

A Randomized Comparison of Sirolimus- Versus Paclitaxel-Eluting Stent Implantation in Patients With Diabetes Mellitus

The Association of Diabetes Mellitus with Clinical Outcomes after Coronary Stenting: A Meta-Analysis

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