Comparison of restenosis rate with sirolimus-eluting stent i n STEMI patients with and without diabetes at 6-month angiographic follow-up

Ma, Shuangtao; Yang, Dachun; Zhang, Xin; Teng, Bing; Li, De; Sun, Meiqin; Yang, Yongjian

doi:10.1080/ac.66.5.2131085

Cited by 11 publications

(8 citation statements)

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“…25 They were also found to have higher FIGURE 4 Multivariable analysis of restenosis and in -stent thrombosis predictors in patients with a history of percutaneous coronary intervention (PCI) who were referred for PCI on admission; A -predictors of in -stent thrombosis; B -predictors of restenosis Abbreviations: see conflicting results. [29][30][31][32] Similar results were described in patients with restenosis after carotid artery stenting. 33 One of the possible explanations is that smokers have a reduced sensitivity to restenosis, and the second is that smokers are more reluctant to seek medical attention despite recurrent angina.…”

Section: Discussionsupporting

confidence: 72%

Chronic obstructive pulmonary disease affects the angiographic presentation and outcomes of patients with coronary artery disease treated with percutaneous coronary interventions

Januszek¹,

Siudak²,

Dziewierz³

et al. 2017

Polish Archives of Internal Medicine

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INTRODUCTION The incidence of chronic obstructive pulmonary disease (COPD) in patients treated with percutaneous coronary intervention (PCI) is underestimated, and the effect of COPD on atherosclerosis and the outcomes of PCI is not fully understood. OBJECTIVES The aim of this study was to assess the impact of COPD on periprocedural outcomes of PCI, as well as its relationship with clinical presentation and the type of coronary artery lesions. PATIENTS AND METHODS Data were prospectively collected using a national electronic registry of PCI procedures performed in Poland between January 2015 and December 2016. Out of the 221 187 PCIs, 5594 patients had been diagnosed with COPD before the intervention. RESULTS Patients with COPD were older than those without COPD (mean [SD] age, 70.3 [9.9] years vs 67 [10.8] years; P <0.001) and more often were males (72.3% vs 67.8%; P <0.001). Non-ST‑segment elevation myocardial infarction (NSTEMI) was a more common clinical presentation of coronary artery disease (CAD) in the COPD group, while ST‑segment elevation myocardial infarction (STEMI) occurred more frequently in the non‑COPD group. Multivessel disease (MVD) with or without left main coronary artery (LMCA) involvement and separate LMCA was diagnosed more often in the COPD group. At baseline, the culprit lesion was more often restenosis and in‑stent thrombosis in the COPD group, whereas de‑novo lesion-in the non‑COPD group. The rates of periprocedural mortality and myocardial infarction did not differ between the groups with and without COPD (0.13% vs 0.12%, P = 0.88 and 0.53% vs 0.45%, P = 0.39, respectively). COPD was found to be an independent predictor of restenosis assessed before PCI in patients with a history of PCI (P = 0.006). CONCLUSIONS Patients with COPD diagnosed before PCI are at an increased risk of MVD with or without LMCA involvement and NSTEMI. Restenosis and in‑stent thrombosis occur more often in patients with COPD before PCI.

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Section: Discussionsupporting

confidence: 72%

Chronic obstructive pulmonary disease affects the angiographic presentation and outcomes of patients with coronary artery disease treated with percutaneous coronary interventions

Januszek¹,

Siudak²,

Dziewierz³

et al. 2017

Polish Archives of Internal Medicine

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“…Our previous clinical follow-up study demonstrated that diabetes remains an independent risk factor for restenosis following DES in coronary arteries (6). There is also evidence that the efficacy of DES in the diabetic state varied with the type of stent (everolimus eluting stents and sirolimus eluting stents > paclitaxel eluting stents and zotarolimus eluting stents) (14).…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that the rate of restenosis remains at 7-16% in diabetic patients who have received DES (5). Our previous study demonstrated that diabetes increases restenosis following rapamycin-eluting stent placement (6), indicating that diabetes remains an important predictor for restenosis in the DES era. When rapamycin becomes less effective at preventing in-stent restenosis, this condition is termed 'rapamycin resistance' (6).…”

Section: Introductionmentioning

confidence: 87%

“…Our previous study demonstrated that diabetes increases restenosis following rapamycin-eluting stent placement (6), indicating that diabetes remains an important predictor for restenosis in the DES era. When rapamycin becomes less effective at preventing in-stent restenosis, this condition is termed 'rapamycin resistance' (6). However, the underlying mechanisms of rapamycin resistance remain to be determined.…”

Section: Introductionmentioning

confidence: 96%

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Expression of mammalian target of rapamycin in atherosclerotic plaques is decreased under diabetic conditions: A mechanism for rapamycin resistance

Zhang

Wang

Yang

et al. 2014

Molecular Medicine Reports

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Our previous study demonstrated that diabetes increases in-stent restenosis following rapamycin-eluting stent placement, which was defined as rapamycin resistance. However, the underlying mechanisms of rapamycin resistance remain to be determined. In the present study, male apolipoprotein E-deficient (ApoE-/-) mice were randomly divided into control and diabetic groups. Diabetes was induced by injecting streptozocin (STZ). The hyperglycemic state, defined as a fasting plasma glucose level >13 mmol/l, was maintained for 8 weeks. At the end of the administration, the plasma levels of triglycerides (TG) and total cholesterol (TC) were significantly elevated in the diabetic group compared with the control mice (all P<0.01). The present study revealed that diabetes increased the atherosclerotic plaque size of the aortic root (P<0.01) and the content of vascular smooth muscle cells (VSMCs) in the atherosclerotic lesion (P<0.01). Furthermore, the protein expression and phosphorylation of mammalian target of rapamycin (mTOR), 4E-binding protein 1 and ribosomal S6 kinase 1 (P<0.01) were significantly decreased in the diabetic mice compared with the control group. The decrease in the expression and phosphorylation of mTOR and its downstream kinases may be one of the molecular mechanisms underlying rapamycin resistance.

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“…In the past, in-stent restenosis (ISR) after bare-metal stent (BMS) implantation is thought to be clinically benign. Recently this notion remains controversial and several studies shows a correlation between ISR of BMS, repeated ACS, ischemic relapses and worse longterm clinical outcomes (10,11,12).…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Transradial Coronary and Renal in Stent Restenosis Treatment in Diabetic Patient with NSTEMI Complicated by Hypertensive Emergency

Summaria

Patrizi²,

Romagnoli³

et al. 2012

Med Arh

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The elderly diabetic patients are increasingly referred for percutaneous coronary interventions during acute coronary syndromes. A nonegligible proportion of this population includes the in stent restenosis as a possible cause of ischemic syndrome. This population accounts an higher risk of ischemic, bleeding and vascular complications affecting the periprocedural management, the length of hospital stay and also the prognosis. The improvement of strategies concerning site of access choice, antithrombotic drug and timing of interventional treatment have significantly reduced the incidence of complications. This paper reports the case of a 76 years-old diabetic female with a high bleeding risk, referred to our hospital because of NSTEMI complicated by pulmonary edema during hypertensive emergency. The patient had a simultaneous in stent restenosis both in left descending coronary artery and left renal artery, undergoing percutaneous transradial treatment during bivalirudin infusion. The clinical, technical, pharmacological and prognostic implications are discussed.

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Comparison of restenosis rate with sirolimus-eluting stent i n STEMI patients with and without diabetes at 6-month angiographic follow-up

Abstract: The present study demonstrated that diabetes increased restenosis after sirolimus-eluting stent placement in STEMI patients. This finding implicates that diabetes remains an important predictor for restenosis in the DES era.

Cited by 11 publications

References 0 publications

Chronic obstructive pulmonary disease affects the angiographic presentation and outcomes of patients with coronary artery disease treated with percutaneous coronary interventions

Chronic obstructive pulmonary disease affects the angiographic presentation and outcomes of patients with coronary artery disease treated with percutaneous coronary interventions

Expression of mammalian target of rapamycin in atherosclerotic plaques is decreased under diabetic conditions: A mechanism for rapamycin resistance

Simultaneous Transradial Coronary and Renal in Stent Restenosis Treatment in Diabetic Patient with NSTEMI Complicated by Hypertensive Emergency

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