Increased Incidence of Coronary In-Stent Restenosis in Type 2 Diabetic Patients is Related to Elevated Serum Malondialdehyde-Modified Low-Density Lipoprotein

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Background Type 2 diabetes mellitus (T2DM) has been reported as a major risk factor for in-stent restenosis (ISR) after intracoronary stenting, although the details of the mechanisms remain undefined. The aim of present study was to investigate the diabetes-related risk factor for ISR. Methods and Results A total of 131 patients who were implanted with bare metal stent(s) were enrolled in this study. Based on follow-up coronary angiography at 6 months after stenting, the patients were classified according to the presence or absence of ISR. Various coronary risk factors, including serum malondialdehyde-modified low-density lipoprotein (MDA-LDL) levels, were investigated at follow-up angiogram to relate to ISR in patients with or without T2DM. The increased incidence of ISR was observed in diabetic patients, which was significantly related to the increased serum MDA-LDL concentrations. The serum MDA-LDL concentration was positively correlated to glycohemoglobin levels in diabetic patients. In addition, MDA-LDL concentration was not altered after the treatment of ISR. Conclusions The elevated serum MDA-LDL level is considered to be a potent risk factor for ISR in diabetic patients. MDA-LDL, which might be a consequence of metabolic abnormalities caused by diabetes, may act as a growth factor for neointimal tissues inside the implanted stent. (Circ J 2007; 71: 1697-1702)
社団法人日本循環器学会の論文
2007-10-20