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

• Published in: Heart and vessels Vol. 31; no. 4; pp. 465 - 473
• Main Authors: Kubo, Takashi, Akasaka, Takashi, Tanimoto, Takashi, Takano, Masamichi, Seino, Yoshitane, Nasu, Kenya, Itoh, Tomonori, Mizuno, Kyoichi, Okura, Hiroyuki, Shinke, Toshiro, Kotani, Jun-ichi, Ito, Shigenori, Yokoi, Hiroyoshi, Muramatsu, Toshiya, Nakamura, Masato, Nanto, Shinsuke
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.04.2016; Springer Nature B.V
• Subjects: Aged; Biomedical Engineering and Bioengineering; Cardiac Surgery; Cardiology; Coronary Angiography - methods; Coronary Artery Disease - complications; Coronary Artery Disease - diagnosis; Coronary Artery Disease - surgery; Coronary Vessels - diagnostic imaging; Coronary Vessels - physiopathology; Coronary Vessels - surgery; Diabetes; Diabetes Mellitus; Drug-Eluting Stents; Electrocardiography; Female; Follow-Up Studies; Heart surgery; Humans; Male; Medicine; Medicine & Public Health; Neointima - pathology; Original Article; Percutaneous Coronary Intervention - methods; Prospective Studies; Stents; Surgical outcomes; Time Factors; Tomography; Tomography, Optical Coherence - methods; Vascular Patency - physiology; Vascular Surgery; Percutaneous coronary intervention; Neointima; Optical coherence tomography; Drug-eluting stents
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-015-0636-6

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.