Third generation drug eluting stent (DES) with biodegradable polymer in diabetic patients: 5 years follow-up

Abstract

Objective To report the long-term safety and efficacy data of a third generation drug eluting stent (DES) with biodegradable polymer in the complex patient population of diabetes mellitus after a follow-up period of 5 years.Background After percutaneous coronary intervention patients with diabetes mellitus are under higher risk of death, restenosis and stent thrombosis (ST) compared to non-diabetic patients.Methods In 126 centers worldwide 3067 patients were enrolled in the NOBORI 2 registry, 888 patients suffered from diabetes mellitus (DM), 213 of them (14%) being insulin dependent (IDDM). Five years follow-up has been completed in this study.ResultsAt 5 years, 89.3% of the patients were available for follow-up. The reported target lesion failure (TLF) rates at 5 years were 12.39% in DM group and 7.34% in non-DM group; (p < 0.0001). In the DM group, the TLF rate in patients with IDDM was significantly higher than in the non-IDDM subgroup (17.84 vs. 10.67%; p < 0.01). The rate of ST at 5 years was not different among diabetic versus non-diabetic patients or IDDM versus NIDDM. Only 10 (<0.4%) very late stent thrombotic events beyond 12 months occurred.ConclusionsThe Nobori DES performed well in patients with DM. As expected patients with DM, particularly those with IDDM, had worse outcomes. However, the very low rate of very late stent thrombosis in IDDM patients might have significant clinical value in the treatment of these patients. Clinical trial registration ISRCTN81649913; http://www.controlled-trials.com/isrctn/search.html?srch=81649913&sort=3&dir=desc&max=10

Thrombus aspiration in hyperglycemic ST-elevation myocardial infarction (STEMI) patients: clinical outcomes at 1-year follow-up

“…A second limitation of our study is that we had no data on surrogate endpoints such as myocardial blush grade, ST-segment resolution, or infarct size. A third limitation is the high use of BMS in the study population that may influence the results [ 34 , 35 ]. Nevertheless, there were no differences between hyperglycemic patients treated with BMS or DES (Additional file 1 : Figure S1).…”

Biodegradable polymer drug-eluting stents versus second-generation drug-eluting stents in patients with and without diabetes mellitus: a single-center study

“…DM is still one of the major risk factors for stent restenosis [ 16 ]. Some studies have shown that patients with DM using BP-DESs, particularly those with insulin-dependent DM, have worse outcomes, such as TLR and mortality, than patients without DM [ 35 , 36 ]. However, a unified view of the long-term clinical efficacy and safety of different generations of DESs among DM patients has not been well established.…”

Photoactive Pore Matrix for In Situ Delivery of a Photosensitizer in Vascular Smooth Muscle Cells Selective PDT

“…Proliferation and migration of tunica media layer (middle coat) smooth muscle cells (SMC) in response to the vascular wall injury, are essential events leading to the subsequent neointimal thickening, which eventually causes vessel narrowing [1]. Therefore, three generations of drug eluting stents (DES) stents were designed with the ability to block SMC proliferation [2]. DES elute antiproliferative drugs into the surrounding tissue, thus indiscriminately block vascular cells [3].…”