Print Email Facebook Twitter Dexamethasone-eluting stents for the prevention of in-stent restenosis: Evidence for a differential effect in insulin-dependent and non-insulin-dependent diabetic patients Title Dexamethasone-eluting stents for the prevention of in-stent restenosis: Evidence for a differential effect in insulin-dependent and non-insulin-dependent diabetic patients Author van der Hoeven, B.L. Pires, N.M.M. Warda, H.M. Putter, H. Quax, P.H.A. Schalij, M.J. Jukema, J.W. TNO Kwaliteit van Leven Publication year 2008 Abstract Diabetes mellitus (DM) is a strong predictor of in-stent restenosis. This may be due to a higher level of vascular inflammation. We hypothesized that diabetic patients will benefit from dexamethasone-eluting stents, since local inflammation and consequently neointimal growth are suppressed and no systemic side effects will occur. Methods: 21 consecutive patients with DM with 32 lesions were treated with dexamethasone-eluting stents. Excluded were patients with triple vessel disease, bifurcation lesions, previous revascularization of the culprit vessel, and reference diameter smaller than 2.5 or larger than 3.75 mm. MACE (death, myocardial infarction, and revascularization) was counted at 12 months. At 6 months, angiographic follow-up was performed. Results: Of the patients, 38% had insulin-dependent DM. Lesion type was type A/B1 in 56% and B2/C in 44%. Lesion length was 15.7 ± 8.4 mm and the reference diameter was 2.83 ± 0.53 mm. Event-free survival at 12 months was 62%. Any revascularization procedure was performed in 33% and target lesion revascularization in 24% of the patients. At 6 months in-stent late loss was 1.07 ± 0.64 mm. Binary restenosis occurred in 28.1% of the lesions. The event-free survival in insulin-dependent DM was worse compared to non-insulin-dependent DM (92.1 vs. 37.8%; p < 0.01). Patients with insulin-dependent DM had higher in-stent late loss compared to non-insulin-dependent DM patients (1.44 ± 0.83 vs. 0.83 ± 0.51 mm; p < 0.01). Conclusion: Treatment with dexamethasone-eluting stents in patients with DM is associated with a relatively high restenosis rate. Our data suggest a differential effect of dexamethasone-eluting stents in insulin-dependent compared to non-insulin-dependent DM. © 2007 Elsevier Ireland Ltd. All rights reserved. Subject HealthDexamethasoneDiabetes mellitusRestenosisdexamethasoneadultagedangiographyarticleclinical articledrug eluting stentdyslipidemiafemalefollow upheart infarctionhumanhypertensioninsulin dependent diabetes mellitusmalenon insulin dependent diabetes mellituspriority journalrestenosisrevascularizationsmokingsurvivalAdolescentAdultAgedAngioplasty, Transluminal, Percutaneous CoronaryCohort StudiesCoronary AngiographyCoronary RestenosisCoronary StenosisDexamethasoneDiabetes Mellitus, Type 1Diabetes Mellitus, Type 2Diabetic AngiopathiesDrug-Eluting StentsFemaleFollow-Up StudiesHumansMaleMiddle AgedProbabilityRisk AssessmentSurvival RateTreatment OutcomeUltrasonography, Interventional To reference this document use: http://resolver.tudelft.nl/uuid:732c0cee-029a-4849-82a7-e70df952ccc8 DOI https://doi.org/10.1016/j.ijcard.2006.12.034 TNO identifier 240663 ISSN 0167-5273 Source International Journal of Cardiology, 124 (2), 166-171 Document type article Files To receive the publication files, please send an e-mail request to TNO Library.