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

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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.

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Abbreviations

J-DESsERT:

Japan-Drug Eluting Stents Evaluation; a Randomized Trial

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Acknowledgments

Non-profit organization (NPO); “Associations for Establishment of Evidence in Interventions” is a sponsor and collaborator of the J-DESsERT trial.

Conflict of interest

All authors have no conflicts of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama, 641-8510, Japan

    Takashi Kubo, Takashi Akasaka & Takashi Tanimoto

  2. Cardiovascular Center, Nippon Medical School, Chiba-Hokusoh Hospital, Chiba, Japan

    Masamichi Takano

  3. Department of Cardiology, Hoshi General Hospital, Koriyama, Japan

    Yoshitane Seino

  4. Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan

    Kenya Nasu

  5. Division of Cardiology, Department of Internal Medicine, Memorial Heart Center, Iwate Medical School, Morioka, Japan

    Tomonori Itoh

  6. Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan

    Kyoichi Mizuno

  7. Division of Cardiology, Kawasaki Medical School, Kurashiki, Japan

    Hiroyuki Okura

  8. Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan

    Toshiro Shinke

  9. Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan

    Jun-ichi Kotani & Shinsuke Nanto

  10. Division of Cardiology, Nagoya City East Medical Center, Nagoya, Japan

    Shigenori Ito

  11. Cardiovascular Medicine Center, Fukuoka Sanno Hospital, Fukuoka, Japan

    Hiroyoshi Yokoi

  12. Division of Cardiology, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan

    Toshiya Muramatsu

  13. Division of Cardiovascular Medicine, Ohashi Medical Center, Toho University, Tokyo, Japan

    Masato Nakamura

Authors
  1. Takashi Kubo
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  2. Takashi Akasaka
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  3. Takashi Tanimoto
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  4. Masamichi Takano
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  6. Kenya Nasu
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  7. Tomonori Itoh
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  8. Kyoichi Mizuno
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  9. Hiroyuki Okura
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  10. Toshiro Shinke
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  11. Jun-ichi Kotani
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  12. Shigenori Ito
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  13. Hiroyoshi Yokoi
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  14. Toshiya Muramatsu
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  15. Masato Nakamura
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  16. Shinsuke Nanto
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Corresponding author

Correspondence to Takashi Kubo.

Additional information

On behalf of the J-DESsERT investigators.

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Kubo, T., Akasaka, T., Tanimoto, T. et al. Assessment of vascular response after drug-eluting stents implantation in patients with diabetes mellitus: an optical coherence tomography sub-study of the J-DESsERT. Heart Vessels 31, 465–473 (2016). https://doi.org/10.1007/s00380-015-0636-6

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  • DOI: https://doi.org/10.1007/s00380-015-0636-6

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