Empagliflozin attenuates neointimal hyperplasia after drug-eluting-stent implantation in patients with type 2 diabetes

Hashikata, Takehiro; Ikutomi, Masayasu; Jimba, Takahiro; Shindo, Akito; Kakuda, Nobutaka; Katsushika, Susumu; Yokoyama, Masaaki; Kishi, Mikio; Sato, Takahiro; Matsushita, Masashiro; Ohnishi, Satoshi; Yamasaki, Masao

doi:10.1007/s00380-020-01621-0

Cited by 19 publications

(13 citation statements)

References 42 publications

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“…The study concerned people after the implantation of second-generation DES due to CHD [103]. Interestingly, empagliflozin has been shown to reduce neointima thickness assessed by optical coherence tomography in post-PCI patients with second-generation DES implantation [104].…”

Section: Neointima Formation and Neoatherosclerosis In Patients With And Without Diabetesmentioning

confidence: 99%

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Jakubiak

Pawlas

Cieślar

et al. 2021

IJERPH

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Diabetes mellitus (DM) is a strong risk factor for the development of cardiovascular diseases such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease (PAD). In the population of people living with DM, PAD is characterised by multi-level atherosclerotic lesions as well as greater involvement of the arteries below the knee. DM is also a factor that significantly increases the risk of lower limb amputation. Percutaneous balloon angioplasty with or without stent implantation is an important method of the treatment for atherosclerotic cardiovascular diseases, but restenosis is a factor limiting its long-term effectiveness. The pathogenesis of atherosclerosis in the course of DM differs slightly from that in the general population. In the population of people living with DM, more attention is drawn to such factors as inflammation, endothelial dysfunction, platelet dysfunction, blood rheological properties, hypercoagulability, and additional factors stimulating vascular smooth muscle cell proliferation. DM is a risk factor for restenosis. The purpose of this paper is to provide a review of the literature and to present the most important information on the current state of knowledge on mechanisms and the clinical significance of restenosis and in-stent restenosis in patients with DM, especially in association with the endovascular treatment of PAD. The role of such processes as inflammation, neointimal hyperplasia and neoatherosclerosis, allergy, resistance to antimitotic drugs used for coating stents and balloons, genetic factors, and technical and mechanical factors are discussed. The information on restenosis collected in this publication may be helpful in planning further research in this field, which may contribute to the formulation of more and more precise recommendations for the clinical practice.

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Section: Neointima Formation and Neoatherosclerosis In Patients With And Without Diabetesmentioning

confidence: 99%

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Jakubiak

Pawlas

Cieślar

et al. 2021

IJERPH

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“…This demonstrated a reduction in neointimal hyperplasia in patients treated with SGLT2 inhibitors versus other oral hypoglycaemic agents 1 year after initiation. Body weight and blood pressure were significantly associated with neointimal hyperplasia changes, but not with blood glucose measurement [75]. Similarly, neointimal hyperplasia reduction with SGLT2 inhibition in injured femoral arteries of high fat diet mice has also been demonstrated [76].…”

Section: Effects Of Sglt2 Inhibitors On Endothelial Functionmentioning

confidence: 92%

The Role of Sodium Glucose Cotransporter-2 Inhibitors in Atherosclerotic Cardiovascular Disease: A Narrative Review of Potential Mechanisms

Barraclough

Patel

et al. 2021

Cells

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Sodium glucose cotransporter 2 (SGLT2) inhibitors are a class of medication with broad cardiovascular benefits in those with type 2 diabetes, chronic kidney disease, and heart failure. These include reductions in major adverse cardiac events and cardiovascular death. The mechanisms that underlie their benefits in atherosclerotic cardiovascular disease (ASCVD) are not well understood, but they extend beyond glucose lowering. This narrative review summarises the ASCVD benefits of SGLT2 inhibitors seen in large human outcome trials, as well as the mechanisms of action explored in rodent and small human studies. Potential pathways include favourable alterations in lipid metabolism, inflammation, and endothelial function. These all require further investigation in large human clinical trials with mechanistic endpoints, to further elucidate the disease modifying benefits of this drug class and those who will benefit most from it.

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“…Similar findings have been observed in humans. A single-centre prospective study investigated the effect of empagliflozin on NIH after DES implantation in patients with type 2 diabetes [177]. The primary endpoint was the thickness of in-stent NIH at 12 months after PCI, assessed by optical coherence tomography (OCT).…”

Section: Pre-clinical and Clinical Evidencementioning

confidence: 99%

Glycaemic Control in Patients Undergoing Percutaneous Coronary Intervention: What Is the Role for the Novel Antidiabetic Agents? A Comprehensive Review of Basic Science and Clinical Data

Nusca

Piccirillo

Bernardini

et al. 2022

IJMS

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Coronary artery disease (CAD) remains one of the most important causes of morbidity and mortality worldwide, and revascularization through percutaneous coronary interventions (PCI) significantly improves survival. In this setting, poor glycaemic control, regardless of diabetes, has been associated with increased incidence of peri-procedural and long-term complications and worse prognosis. Novel antidiabetic agents have represented a paradigm shift in managing patients with diabetes and cardiovascular diseases. However, limited data are reported so far in patients undergoing coronary stenting. This review intends to provide an overview of the biological mechanisms underlying hyperglycaemia-induced vascular damage and the contrasting actions of new antidiabetic drugs. We summarize existing evidence on the effects of these drugs in the setting of PCI, addressing pre-clinical and clinical studies and drug-drug interactions with antiplatelet agents, thus highlighting new opportunities for optimal long-term management of these patients.

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Empagliflozin attenuates neointimal hyperplasia after drug-eluting-stent implantation in patients with type 2 diabetes

Cited by 19 publications

References 42 publications

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

The Role of Sodium Glucose Cotransporter-2 Inhibitors in Atherosclerotic Cardiovascular Disease: A Narrative Review of Potential Mechanisms

Glycaemic Control in Patients Undergoing Percutaneous Coronary Intervention: What Is the Role for the Novel Antidiabetic Agents? A Comprehensive Review of Basic Science and Clinical Data

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