Serial intravascular ultrasound analysis of peri-stent remodeling and proximal and distal edge effects after sirolimus-eluting or paclitaxel-eluting stent implantation in patients with diabetes mellitus

Lisette Okkels Jensen, Michael Maeng, Gary S Mintz, Evald Hoej Christiansen, Knud Noerregaard Hansen, Anders Galloe, Henning Kelbaek, Jens Flensted Lassen, Leif Thuesen, Per Thayssen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Udgivelsesdato: 2009-Apr-15
OriginalsprogEngelsk
TidsskriftAmerican Journal of Cardiology
Vol/bind103
Udgave nummer8
Sider (fra-til)1083-8
Antal sider5
ISSN0002-9149
DOI
StatusUdgivet - 15. apr. 2009

Fingeraftryk

Stents
Diabetes Mellitus
Taxus
Membranes
Coronary Restenosis
Acer
Lakes

Citer dette

@article{dc122da0e4a111deaefb000ea68e967b,
title = "Serial intravascular ultrasound analysis of peri-stent remodeling and proximal and distal edge effects after sirolimus-eluting or paclitaxel-eluting stent implantation in patients with diabetes mellitus",
abstract = "Patients with diabetes have an increased risk of in-stent restenosis after coronary stent implantation. Serial intravascular ultrasound was used to study chronic arterial responses and edge effects after implantation of Cypher (Cordis, Johnson & Johnson, Miami Lakes, Florida) or Taxus (Boston Scientific, Maple Grove, Minnesota) stents in diabetic patients. Seventy-four diabetic patients were randomly assigned to Cypher or Taxus stent implantation. Intravascular ultrasound of 5-mm long segments immediately proximal and distal to the stent was performed after the procedure and at the 8-month follow-up. The increase in peri-stent external elastic membrane (EEM) volume was more pronounced in the Taxus group (292.4 +/- 132.6 to 309.5 +/- 146.8 mm(3)) than in the Cypher group (274.4 +/- 137.2 to 275.4 +/- 140.1 mm(3); p = 0.005). Peri-stent plaque volume increased in the Taxus group (152.5 +/- 73.7 to 166.1 +/- 85.1 mm(3)), but was unchanged in the Cypher group (153.5 +/- 75.5 to 151.5 +/- 75.8 mm(3); p = 0.002). In proximal and distal reference segments, mean lumen area decreased within the entire 5-mm edge segment (proximal and distal) because of plaque progression (distal, 5.5 +/- 3.6 to 5.8 +/- 3.7 mm(2); p = 0.097; proximal, 8.1 +/- 2.7 to 8.7 +/- 2.9 mm(2); p = 0.006) without remodeling (change in EEM) in the Taxus group. Conversely, there were no significant changes in reference-segment EEM or plaque areas in the Cypher group. In conclusion, in diabetic patients, Taxus stent implantation was associated with increased (1) peri-stent EEM volume and peri-stent plaque, and (2) stent edge plaque progression accompanied by lumen reduction without remodeling. These findings were not seen in Cypher stents.",
keywords = "Aged, Angioplasty, Transluminal, Percutaneous Coronary, Coronary Restenosis, Diabetes Complications, Drug-Eluting Stents, Female, Humans, Immunosuppressive Agents, Male, Middle Aged, Paclitaxel, Sirolimus, Ultrasonography, Interventional",
author = "Jensen, {Lisette Okkels} and Michael Maeng and Mintz, {Gary S} and Christiansen, {Evald Hoej} and Hansen, {Knud Noerregaard} and Anders Galloe and Henning Kelbaek and Lassen, {Jens Flensted} and Leif Thuesen and Per Thayssen",
year = "2009",
month = "4",
day = "15",
doi = "10.1016/j.amjcard.2008.12.035",
language = "English",
volume = "103",
pages = "1083--8",
journal = "The American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier",
number = "8",

}

Serial intravascular ultrasound analysis of peri-stent remodeling and proximal and distal edge effects after sirolimus-eluting or paclitaxel-eluting stent implantation in patients with diabetes mellitus. / Jensen, Lisette Okkels; Maeng, Michael; Mintz, Gary S; Christiansen, Evald Hoej; Hansen, Knud Noerregaard; Galloe, Anders; Kelbaek, Henning; Lassen, Jens Flensted; Thuesen, Leif; Thayssen, Per.

I: American Journal of Cardiology, Bind 103, Nr. 8, 15.04.2009, s. 1083-8.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Serial intravascular ultrasound analysis of peri-stent remodeling and proximal and distal edge effects after sirolimus-eluting or paclitaxel-eluting stent implantation in patients with diabetes mellitus

AU - Jensen, Lisette Okkels

AU - Maeng, Michael

AU - Mintz, Gary S

AU - Christiansen, Evald Hoej

AU - Hansen, Knud Noerregaard

AU - Galloe, Anders

AU - Kelbaek, Henning

AU - Lassen, Jens Flensted

AU - Thuesen, Leif

AU - Thayssen, Per

PY - 2009/4/15

Y1 - 2009/4/15

N2 - Patients with diabetes have an increased risk of in-stent restenosis after coronary stent implantation. Serial intravascular ultrasound was used to study chronic arterial responses and edge effects after implantation of Cypher (Cordis, Johnson & Johnson, Miami Lakes, Florida) or Taxus (Boston Scientific, Maple Grove, Minnesota) stents in diabetic patients. Seventy-four diabetic patients were randomly assigned to Cypher or Taxus stent implantation. Intravascular ultrasound of 5-mm long segments immediately proximal and distal to the stent was performed after the procedure and at the 8-month follow-up. The increase in peri-stent external elastic membrane (EEM) volume was more pronounced in the Taxus group (292.4 +/- 132.6 to 309.5 +/- 146.8 mm(3)) than in the Cypher group (274.4 +/- 137.2 to 275.4 +/- 140.1 mm(3); p = 0.005). Peri-stent plaque volume increased in the Taxus group (152.5 +/- 73.7 to 166.1 +/- 85.1 mm(3)), but was unchanged in the Cypher group (153.5 +/- 75.5 to 151.5 +/- 75.8 mm(3); p = 0.002). In proximal and distal reference segments, mean lumen area decreased within the entire 5-mm edge segment (proximal and distal) because of plaque progression (distal, 5.5 +/- 3.6 to 5.8 +/- 3.7 mm(2); p = 0.097; proximal, 8.1 +/- 2.7 to 8.7 +/- 2.9 mm(2); p = 0.006) without remodeling (change in EEM) in the Taxus group. Conversely, there were no significant changes in reference-segment EEM or plaque areas in the Cypher group. In conclusion, in diabetic patients, Taxus stent implantation was associated with increased (1) peri-stent EEM volume and peri-stent plaque, and (2) stent edge plaque progression accompanied by lumen reduction without remodeling. These findings were not seen in Cypher stents.

AB - Patients with diabetes have an increased risk of in-stent restenosis after coronary stent implantation. Serial intravascular ultrasound was used to study chronic arterial responses and edge effects after implantation of Cypher (Cordis, Johnson & Johnson, Miami Lakes, Florida) or Taxus (Boston Scientific, Maple Grove, Minnesota) stents in diabetic patients. Seventy-four diabetic patients were randomly assigned to Cypher or Taxus stent implantation. Intravascular ultrasound of 5-mm long segments immediately proximal and distal to the stent was performed after the procedure and at the 8-month follow-up. The increase in peri-stent external elastic membrane (EEM) volume was more pronounced in the Taxus group (292.4 +/- 132.6 to 309.5 +/- 146.8 mm(3)) than in the Cypher group (274.4 +/- 137.2 to 275.4 +/- 140.1 mm(3); p = 0.005). Peri-stent plaque volume increased in the Taxus group (152.5 +/- 73.7 to 166.1 +/- 85.1 mm(3)), but was unchanged in the Cypher group (153.5 +/- 75.5 to 151.5 +/- 75.8 mm(3); p = 0.002). In proximal and distal reference segments, mean lumen area decreased within the entire 5-mm edge segment (proximal and distal) because of plaque progression (distal, 5.5 +/- 3.6 to 5.8 +/- 3.7 mm(2); p = 0.097; proximal, 8.1 +/- 2.7 to 8.7 +/- 2.9 mm(2); p = 0.006) without remodeling (change in EEM) in the Taxus group. Conversely, there were no significant changes in reference-segment EEM or plaque areas in the Cypher group. In conclusion, in diabetic patients, Taxus stent implantation was associated with increased (1) peri-stent EEM volume and peri-stent plaque, and (2) stent edge plaque progression accompanied by lumen reduction without remodeling. These findings were not seen in Cypher stents.

KW - Aged

KW - Angioplasty, Transluminal, Percutaneous Coronary

KW - Coronary Restenosis

KW - Diabetes Complications

KW - Drug-Eluting Stents

KW - Female

KW - Humans

KW - Immunosuppressive Agents

KW - Male

KW - Middle Aged

KW - Paclitaxel

KW - Sirolimus

KW - Ultrasonography, Interventional

U2 - 10.1016/j.amjcard.2008.12.035

DO - 10.1016/j.amjcard.2008.12.035

M3 - Journal article

VL - 103

SP - 1083

EP - 1088

JO - The American Journal of Cardiology

JF - The American Journal of Cardiology

SN - 0002-9149

IS - 8

ER -