The influence of glycemic control in diabetic patients on neointimal hyperplasia after coronary stent implantation

Natsuo Inoue, Mamoru Nanasato, Kazumasa Unno, Masayuki Shimano, Mikihito Takefuji, Kunihiro Matsushita, Yukihiko Yoshida, Hiroto Takezawa, Satoru Miwata, Naoya Tsuboi, Haruo Hirayama

Research output: Contribution to journalArticle

Abstract

Background and Purpose: Several studies have shown diabetes mellitus (DM) is a predictor of restenosis after coronary stenting. There is little information, however, about the effect of glycemic control in diabetic patients on in-stent neointimal hyperplasia. Methods and Subjects: Serial (post-intervention and six-month follow-up) intravascular ultrasound (IVUS) was used to study 87 lesions treated with single slotted-tube stents (Multi-Link or NIR) in 80 diabetic patients. We measured cross sectional stent area (SCSA), cross-sectional lumen area (LCSA) at the axial location within the stents at the smallest follow-up area. Cross-sectional percent neointimal area (%NICSA) was calculated as below: %NICSA = (SCSA-LCSA)/SCSA × 100. HbA1C levels and fasting blood glucose (FBG) levels were measured at six-month follow-up. Good-controlled DM was defined as mean HbA1C <6.5% and mean FBG <140 mg/dl, and poor-controlled DM was defined as mean HbA1C ≳ 6.5% or mean FBG ≳ 140 mg/dl. Results: There were 42 lesions with good-controlled DM, and 45 with poor-controlled DM. No significant difference was observed between the two groups in gender, age, coronary risk factors, and SCSA at follow-up. %NICSA was greater in patients with poor-controlled DM than that in patients with good-controlled DM (34 ± 15% vs 44 ± 18%; p = 0.008). Conclusions: Glycemic control in diabetic patients plays an important roll in neointimal proliferation after stent implantation.

Original languageEnglish (US)
Pages (from-to)163-167
Number of pages5
JournalJapanese Journal of Interventional Cardiology
Volume18
Issue number2
Publication statusPublished - 2003
Externally publishedYes

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Keywords

  • Diabetes mellitus
  • Neointimal hyperplasia
  • Stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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