Predictors of strut coverage of drug eluting stent implantation in diabetic patients.
Aged
Clopidogrel
/ administration & dosage
Coronary Artery Disease
/ diagnostic imaging
Diabetes Mellitus
/ diagnostic imaging
Drug-Eluting Stents
/ adverse effects
Female
Follow-Up Studies
Humans
Immunosuppressive Agents
/ administration & dosage
Male
Middle Aged
Platelet Aggregation Inhibitors
/ administration & dosage
Predictive Value of Tests
Prosthesis Design
/ adverse effects
Sirolimus
/ administration & dosage
Tomography, Optical Coherence
/ trends
Treatment Outcome
Clopidogrel resistance
Diabetes mellitus
Drug eluting stent
Optical coherence tomography
Journal
International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291
Informations de publication
Date de publication:
01 Feb 2019
01 Feb 2019
Historique:
received:
31
07
2018
revised:
15
10
2018
accepted:
08
11
2018
pubmed:
27
11
2018
medline:
28
8
2019
entrez:
27
11
2018
Statut:
ppublish
Résumé
Incomplete re-endothelialization of drug eluting stent (DES) segments has been associated with the occurrence of major adverse cardiac events after DES implantation. It is unknown whether on-clopidogrel platelet reactivity (OPR) and/or circulating endothelial progenitor cells (EPC) levels may predict uncovered strut rate in diabetic patients treated by DES implantation. One-hundred and five diabetic patients undergoing elective DES implantation were included into the study. EPC levels and OPR were assessed at 24 h (baseline) and 3 months. EPC were evaluated by flow cytometric analysis and defined by the co-expression of the markers CD34 and KDR. OPR was assessed using the impedance aggregometer. The degree of DES re-endothelialization was assessed at 3 months by optical coherence tomography. A direct correlation was observed between the uncovered strut rate and OPR both at baseline (r = 0.47: p < 0.001) and at the 3 months (r = 0.25: p = 0.015). On the contrary, we found no significant correlation between EPC level and uncovered strut rate either at baseline (r = -0.02; p = 0.85) or at 3 months (r = -0.06; p = 0.13). By multivariable regression analysis, independent predictors of uncovered strut rate > 5% were complex lesions (OR = 5.35; 95% confidence interval 1.32-17.57; p = 0.027) and OPR at baseline (OR = 4.73; 95% confidence interval 1.04-8.14; p = 0.039). In diabetic patients treated with DES implantation OPR at baseline and complex lesions are independent predictors of uncovered strut rate at 3 months.
Sections du résumé
BACKGROUND
BACKGROUND
Incomplete re-endothelialization of drug eluting stent (DES) segments has been associated with the occurrence of major adverse cardiac events after DES implantation. It is unknown whether on-clopidogrel platelet reactivity (OPR) and/or circulating endothelial progenitor cells (EPC) levels may predict uncovered strut rate in diabetic patients treated by DES implantation.
METHODS
METHODS
One-hundred and five diabetic patients undergoing elective DES implantation were included into the study. EPC levels and OPR were assessed at 24 h (baseline) and 3 months. EPC were evaluated by flow cytometric analysis and defined by the co-expression of the markers CD34 and KDR. OPR was assessed using the impedance aggregometer. The degree of DES re-endothelialization was assessed at 3 months by optical coherence tomography.
RESULTS
RESULTS
A direct correlation was observed between the uncovered strut rate and OPR both at baseline (r = 0.47: p < 0.001) and at the 3 months (r = 0.25: p = 0.015). On the contrary, we found no significant correlation between EPC level and uncovered strut rate either at baseline (r = -0.02; p = 0.85) or at 3 months (r = -0.06; p = 0.13). By multivariable regression analysis, independent predictors of uncovered strut rate > 5% were complex lesions (OR = 5.35; 95% confidence interval 1.32-17.57; p = 0.027) and OPR at baseline (OR = 4.73; 95% confidence interval 1.04-8.14; p = 0.039).
CONCLUSIONS
CONCLUSIONS
In diabetic patients treated with DES implantation OPR at baseline and complex lesions are independent predictors of uncovered strut rate at 3 months.
Identifiants
pubmed: 30473337
pii: S0167-5273(18)34740-5
doi: 10.1016/j.ijcard.2018.11.025
pii:
doi:
Substances chimiques
Immunosuppressive Agents
0
Platelet Aggregation Inhibitors
0
Clopidogrel
A74586SNO7
Sirolimus
W36ZG6FT64
Types de publication
Clinical Trial, Phase I
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
61-65Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2018 Elsevier B.V. All rights reserved.