Vascular Responses in Patients With and Without Diabetes Mellitus After Everolimus-Eluting Stent Implantation:– Optical Coherence Tomography Study –
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概要
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Background:Previous reports have shown potential disadvantages of limus-derivative drugs for the stenting treatment of patients with diabetes mellitus (DM).Methods and Results:We studied 159 coronary artery lesions (DM: n=72, non-DM: n=87) in 123 patients treated with everolimus-eluting stent (EES) and who underwent scheduled 9-month follow-up angiography with optical coherence tomography (OCT) regardless of symptoms. In addition to standard OCT variables, neointimal unevenness score (maximum/average neointimal thickness) and stent eccentricity index (minimum/maximum stent diameter) were calculated for each cross-section. To investigate a potential baseline difference between DM and non-DM lesions, pre- and post-interventional intravascular ultrasound (IVUS) images were also evaluated as an IVUS subgroup analysis. The average neointimal thickness and neointimal coverage did not differ between DM and non-DM patients. DM patients had, however, greater asymmetric stent expansion and variability of neointimal thickness than non-DM patients. There was a weak, but significant association between average stent eccentricity index and neointimal unevenness score. The IVUS substudy showed that the culprit plaque volume and plaque eccentricity in DM patients were significantly greater than in non-DM patients.Conclusions:Although EES provided a similar level of average neointimal thickness and coverage both in the presence and absence of DM, uneven neointimal suppression occurred in DM patients. A larger plaque volume of the culprit lesion may hamper symmetric stent expansion, possibly explaining the non-uniform neointimal suppression in DM patients. (Circ J2014;78:2188–2196)
- 一般社団法人 日本循環器学会の論文
著者
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Inoue Takumi
Division of Cardiology, Hjimeji Cardiovascular Center
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Shinke Toshiro
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University
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Taniguchi Yu
Division of Cardiology, Heart Institute, Chiba-Nishi General Hospital
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Hirata Ken-ichi
Division Of Cardiovascular Medicine Department Of Internal Medicine Kobe University Graduate School
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Nakagawa Masayuki
Division Of Cardiovascular Medicine Department Of Internal Medicine Kobe University Graduate School
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Otake Hiromasa
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University Graduate School Of Medicine
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Kinutani Hiroto
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University Graduate School Of Medicine
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Nishio Ryo
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University Graduate School Of Medicine
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Hiranuma Noritoshi
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University Graduate School Of Medicine
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Shite Junya
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University Graduate School Of Medicine
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Osue Tsuyoshi
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University Graduate School Of Medicine
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KINUTANI Hiroto
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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Konishi Akihide
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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Iwasaki Masamichi
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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Hariki Hirotoshi
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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Kuroda Masaru
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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Taniguchi Yu
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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HIRATA Ken-ichi
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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Konishi Akihide
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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