Neointimal response to second-generation drug-eluting stents in diabetic patients with de-novo coronary lesions: intravascular ultrasound study

Coron Artery Dis. 2015 May;26(3):212-9. doi: 10.1097/MCA.0000000000000195.

Abstract

Objectives: The aim of this study was to evaluate the extent of neointimal response after the implantation of a second-generation drug-eluting stent, zotarolimus-eluting stent (ZES-ER, Endeavor Resolute) or everolimus-eluting stent (EES, Xience V), using intravascular ultrasound (IVUS) in diabetic patients.

Materials and methods: In all, 154 diabetic patients with de-novo coronary lesions were randomized to be implanted with a ZES-ER or EES, and the angiographic follow-up at 9 months combined with a complete IVUS study was available for 96 patients with 101 lesions.

Results: Baseline demographic and lesion parameters were similar in both groups at index percutaneous coronary intervention. On follow-up angiography, in-stent late lumen loss and minimal lumen diameter were not different between the two groups. On IVUS study, neointimal hyperplasia volume [median (interquartile range): ZES-ER vs. EES; 2.25 mm (0.57-6.25) vs. 1.59 mm (0.45-8.37), P=0.615] and in-stent percentage of volume obstruction [median (interquartile range): ZES-ER vs. EES; 1.16% (0.33-3.61) vs. 0.77% (0.29-4.01), P=0.615] showed similar results between the two groups.

Conclusion: In diabetic patients, the second-generation drug-eluting stents, ZES-ER and EES, were comparable in inhibiting neointimal proliferation.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cardiovascular Agents / administration & dosage*
  • Coronary Angiography
  • Coronary Restenosis / diagnostic imaging
  • Coronary Restenosis / etiology
  • Coronary Restenosis / pathology
  • Coronary Restenosis / prevention & control*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / drug effects*
  • Coronary Vessels / pathology
  • Diabetic Angiopathies / diagnosis
  • Diabetic Angiopathies / therapy*
  • Drug-Eluting Stents*
  • Everolimus / administration & dosage
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neointima*
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Pilot Projects
  • Predictive Value of Tests
  • Prosthesis Design
  • Republic of Korea
  • Risk Factors
  • Sirolimus / administration & dosage
  • Sirolimus / analogs & derivatives
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Interventional*

Substances

  • Cardiovascular Agents
  • Everolimus
  • zotarolimus
  • Sirolimus