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(Circulation. 2004;109:861-866.)
© 2004 American Heart Association, Inc.

Clinical Investigation and Reports

Volumetric Analysis of In-Stent Intimal Hyperplasia in Diabetic Patients Treated With or Without Abciximab

Results of the Diabetes Abciximab steNT Evaluation (DANTE) Randomized Trial

Áurea J. Chaves, MD; Amanda G.M.R. Sousa, MD, PhD; Luiz A. Mattos, MD, PhD; Alexandre Abizaid, MD, PhD; Rodolfo Staico, MD; Fausto Feres, MD, PhD; Marinella Centemero, MD; Luiz F. Tanajura, MD; Andrea Abizaid, MD, PhD; Ibraim Pinto, MD, PhD; Galo Maldonado, MD; Ana Seixas, MD; Marco A. Costa, MD, PhD; Ângela Paes, MSc; Gary S. Mintz, MD; J. Eduardo Sousa, MD, PhD

From Instituto "Dante Pazzanese" de Cardiologia, São Paulo, Brazil; and the Cardiovascular Research Foundation (G.S.M.), New York, NY.

Correspondence to Prof J. Eduardo Sousa, Instituto "Dante Pazzanese" de Cardiologia, Av. Dr. Dante Pazzanese, 500-04012180, São Paulo, Brazil. E-mail jesousa{at}uol.com.br

Received September 12, 2003; revision received November 9, 2003; accepted November 25, 2003.

Background— In diabetic patients in the Evaluation of Platelet IIb/IIIa Inhibitor for Stenting (EPISTENT) trial, abciximab reduced target vessel revascularization by 50% compared with placebo. Whether this is a result of a lower restenosis rate caused by inhibition of intimal hyperplasia remains to be defined.

Methods and Results— The purpose of this study was to determine whether abciximab at the time of stent implantation would reduce in-stent intimal hyperplasia measured by intravascular ultrasound at 6-month follow-up in type 2 diabetics. Ninety-six diabetic patients (96 lesions) who underwent elective stent implantation for a de novo lesion in a native coronary artery were randomly assigned to receive abciximab or no abciximab. In-stent intimal hyperplasia volume, expressed as percentage of stent volume, did not differ between groups: 41.3±21.0% for those treated with abciximab versus 40.5±18.3% for those treated without abciximab (P=0.9). There were also no significant differences in angiographic minimal luminal diameter at follow-up (1.74±0.69 versus 1.66±0.63 mm; P=0.5), late loss (1.03±0.63 versus 1.07±0.58 mm; P=0.7), restenosis rate (17.8% versus 22.9%; P=0.5), or cumulative incidence of major adverse cardiac events at 12 months (19.1% versus 20.4%; P=0.9).

Conclusions— Six-month intravascular ultrasound volumetric analysis showed that abciximab, at the time of coronary stent implantation, was not associated with a reduction of in-stent intimal hyperplasia in diabetic patients.

Key Words: diabetes mellitus • stents • glycoproteins • ultrasonics

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