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Diabetes Mellitus Does Not Increase the Risk of Adverse Long-Term Outcomes After Intracranial Stent Placement

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Abstract

The present study is to investigate whether diabetes mellitus (DM) increases risk of adverse long-term outcomes after intracranial stent placement. Patients receiving intracranial stenting were assigned to DM group and non-DM group according to diabetes status. The long-term follow-up endpoint was composite of any stroke and death within 30 days, any ischemic stroke beyond 30 days, and transient ischemic attack in the territory of the stented artery at any time. A total of 44 stenoses in 43 patients were retrospectively analyzed. The cumulative probability of the composite outcomes were 15.4 % (95 % CI 15.3–47.3 %) at 1 year and 30.8 % (95 % CI 26.5–33.6 %) at 2 years for DM group; 17.5 % (95 % CI 16.0–31.2 %) at both 1 year and 2 years for non-DM group (log-rank test, P = 0.424). After adjusting for the confounders, the risk of DM versus non-DM for composite outcomes remained insignificant (hazard ratio: 2.84, 95 % CI 0.46–17.66; P = 0.26). Our results showed that there is no significant difference between patients with DM and without DM in cumulative probability of the composite outcomes. It suggests that based on our data, there is no evidence that DM increases the risk of adverse long-term outcomes after intracranial stent placement.

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References

  1. Mazighi, M., Tanasescu, R., Ducrocq, X., Vicaut, E., Bracard, S., et al. (2006). Prospective study of symptomatic atherothrombotic intracranial stenoses: the GESICA study. Neurology, 66, 1187–1191.

    Article  CAS  PubMed  Google Scholar 

  2. Rincon, F., Sacco, R. L., Kranwinkel, G., Xu, Q., Paik, M. C., et al. (2009). Incidence and risk factors of intracranial atherosclerotic stroke: the Northern Manhattan Stroke Study. Cerebrovascular Diseases, 28, 65–71.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Thijs, V. N., & Albers, G. W. (2000). Symptomatic intracranial atherosclerosis: outcome of patients who fail antithrombotic therapy. Neurology, 55, 490–497.

    Article  CAS  PubMed  Google Scholar 

  4. Kern, R., Steinke, W., Daffertshofer, M., Prager, R., & Hennerici, M. (2005). Stroke recurrences in patients with symptomatic vs asymptomatic middle cerebral artery disease. Neurology, 65, 859–864.

    Article  CAS  PubMed  Google Scholar 

  5. Chimowitz, M. I., Lynn, M. J., Howlett-Smith, H., Stern, B. J., Hertzberg, V. S., et al. (2005). Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. New England Journal of Medicine, 352, 1305–1316.

    Article  CAS  PubMed  Google Scholar 

  6. Kasner, S. E., Chimowitz, M. I., Lynn, M. J., Howlett-Smith, H., Stern, B. J., et al. (2006). Predictors of ischemic stroke in the territory of a symptomatic intracranial arterial stenosis. Circulation, 113, 555–563.

    Article  PubMed  Google Scholar 

  7. Investigators, S. S. (2004). Stenting of Symptomatic Atherosclerotic Lesions in the Vertebral or Intracranial Arteries (SSYLVIA): study results. Stroke, 35, 1388–1392.

    Article  Google Scholar 

  8. Higashida, R. T., Meyers, P. M., Connors, J. J., Sacks, D., Strother, C. M., et al. (2005). Intracranial angioplasty & stenting for cerebral atherosclerosis: a position statement of the American Society of Interventional and Therapeutic Neuroradiology, Society of Interventional Radiology, and the American Society of Neuroradiology. Journal of Vascular and Interventional Radiology, 16, 1281–1285.

    Article  PubMed  Google Scholar 

  9. Lylyk, P., Vila, J. F., Miranda, C., Ferrario, A., Musacchio, A., et al. (2005). Endovascular reconstruction by means of stent placement in symptomatic intracranial atherosclerotic stenosis. Neurological Research, 27(Suppl 1), S84–S88.

    Article  PubMed  Google Scholar 

  10. Wong, K. S., Huang, Y. N., Yang, H. B., Gao, S., Li, H., et al. (2007). A door-to-door survey of intracranial atherosclerosis in Liangbei County, China. Neurology, 68, 2031–2034.

    Article  CAS  PubMed  Google Scholar 

  11. Park, J. H., Hong, K. S., Lee, E. J., Lee, J., & Kim, D. E. (2011). High levels of apolipoprotein B/AI ratio are associated with intracranial atherosclerotic stenosis. Stroke, 42, 3040–3046.

    Article  CAS  PubMed  Google Scholar 

  12. Qureshi, A. I., Tariq, N., Hassan, A. E., Vazquez, G., Hussein, H. M., et al. (2011). Predictors and timing of neurological complications following intracranial angioplasty and/or stent placement. Neurosurgery, 68, 53–60. discussion 60–51.

    Article  PubMed  Google Scholar 

  13. Jiang, W. J., Yu, W., Du, B., Gao, F., & Cui, L. Y. (2011). Outcome of patients with >/=70 % symptomatic intracranial stenosis after Wingspan stenting. Stroke, 42, 1971–1975.

    Article  PubMed  Google Scholar 

  14. North American Symptomatic Carotid Endarterectomy Trial Collaborators. (1991). Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. New England Journal of Medicine, 325, 445–453.

    Article  Google Scholar 

  15. Axelrod, D. A., Upchurch, G. R, Jr, DeMonner, S., Stanley, J. C., Khuri, S., et al. (2002). Perioperative cardiovascular risk stratification of patients with diabetes who undergo elective major vascular surgery. Journal of Vascular Surgery, 35, 894–901.

    Article  PubMed  Google Scholar 

  16. Hofmann, R., Niessner, A., Kypta, A., Steinwender, C., Kammler, J., et al. (2006). Risk score for peri-interventional complications of carotid artery stenting. Stroke, 37, 2557–2561.

    Article  PubMed  Google Scholar 

  17. Schluter, M., Reimers, B., Castriota, F., Tubler, T., Cernetti, C., et al. (2007). Impact of diabetes, patient age, and gender on the 30-day incidence of stroke and death in patients undergoing carotid artery stenting with embolus protection: a post hoc subanalysis of a prospective multicenter registry. Journal of Endovascular Therapy, 14, 271–278.

    Article  PubMed  Google Scholar 

  18. Siewiorek, G. M., Krafty, R. T., Wholey, M. H., & Finol, E. A. (2011). The association of clinical variables and filter design with carotid artery stenting thirty-day outcome. European Journal of Vascular and Endovascular Surgery, 42, 282–291.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Miao, Z. R., Feng, L., Li, S., Zhu, F., Ji, X., et al. (2009). Treatment of symptomatic middle cerebral artery stenosis with balloon-mounted stents: long-term follow-up at a single center. Neurosurgery, 64, 79–84. discussion 84–75.

    Article  PubMed  Google Scholar 

  20. Zhu, S. G., Zhang, R. L., Liu, W. H., Yin, Q., Zhou, Z. M., et al. (2010). Predictive factors for in-stent restenosis after balloon-mounted stent placement for symptomatic intracranial atherosclerosis. European Journal of Vascular and Endovascular Surgery, 40, 499–506.

    Article  CAS  PubMed  Google Scholar 

  21. Kim, J. K., Ahn, J. Y., Lee, B. H., Chung, Y. S., Chung, S. S., et al. (2004). Elective stenting for symptomatic middle cerebral artery stenosis presenting as transient ischaemic deficits or stroke attacks: short term arteriographical and clinical outcome. Journal of Neurology, Neurosurgery and Psychiatry, 75, 847–851.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  22. Fiorella, D., Chow, M. M., Anderson, M., Woo, H., Rasmussen, P. A., et al. (2007). A 7-year experience with balloon-mounted coronary stents for the treatment of symptomatic vertebrobasilar intracranial atheromatous disease. Neurosurgery, 61, 236–242. discussion 242–233.

    Article  PubMed  Google Scholar 

  23. Jiang, W. J., Srivastava, T., Gao, F., Du, B., Dong, K. H., et al. (2006). Perforator stroke after elective stenting of symptomatic intracranial stenosis. Neurology, 66, 1868–1872.

    Article  CAS  PubMed  Google Scholar 

  24. Nahab, F., Lynn, M. J., Kasner, S. E., Alexander, M. J., Klucznik, R., et al. (2009). Risk factors associated with major cerebrovascular complications after intracranial stenting. Neurology, 72, 2014–2019.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. Carmassi, F., Morale, M., Puccetti, R., De Negri, F., Monzani, F., et al. (1992). Coagulation and fibrinolytic system impairment in insulin dependent diabetes mellitus. Thrombosis Research, 67, 643–654.

    Article  CAS  PubMed  Google Scholar 

  26. Aronson, D. (2002). Potential role of advanced glycosylation end products in promoting restenosis in diabetes and renal failure. Medical Hypotheses, 59, 297–301.

    Article  CAS  PubMed  Google Scholar 

  27. Redgrave, J. N., Lovett, J. K., Syed, A. B., & Rothwell, P. M. (2008). Histological features of symptomatic carotid plaques in patients with impaired glucose tolerance and diabetes (oxford plaque study). Cerebrovascular diseases, 26, 79–86.

    Article  CAS  PubMed  Google Scholar 

  28. Amano, T., Matsubara, T., Uetani, T., Nanki, M., Marui, N., et al. (2008). Abnormal glucose regulation is associated with lipid-rich coronary plaque: relationship to insulin resistance. JACC Cardiovascular Imaging, 1, 39–45.

    Article  PubMed  Google Scholar 

  29. Kunte, H., Schmidt, S., Eliasziw, M., del Zoppo, G. J., Simard, J. M., et al. (2007). Sulfonylureas improve outcome in patients with type 2 diabetes and acute ischemic stroke. Stroke, 38, 2526–2530.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

This study was supported by Grants from the National Natural Science Foundation of China (81271282), Natural Science Foundation Project of CQ CSTC (CSTC2012JJJQ10003).

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Correspondence to Li-Li Zhang or Jing-Cheng Li.

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Li, BH., Yin, YW., Gao, CY. et al. Diabetes Mellitus Does Not Increase the Risk of Adverse Long-Term Outcomes After Intracranial Stent Placement. Cell Biochem Biophys 71, 413–418 (2015). https://doi.org/10.1007/s12013-014-0214-z

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  • DOI: https://doi.org/10.1007/s12013-014-0214-z

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