(Circulation. 1997;95:1366-1369.)
© 1997 American Heart Association, Inc.
Articles |
Increased Restenosis in Diabetes Mellitus After Coronary Interventions Is Due to Exaggerated Intimal Hyperplasia
A Serial Intravascular Ultrasound Study
the Intravascular Imaging and Cardiac Catheterization Laboratories, Washington (DC) Hospital Center.
Correspondence to Martin B. Leon, MD, Director of Research, Washington Cardiology Center, 110 Irving St NW, Suite 4B1, Washington, DC 20010.
 |
Abstract |
|---|
 Top Abstract IntroductionMethodsResultsDiscussionReferences |
|---|
Background The increased risk of restenosis after catheter-based coronary interventions in diabetic patients has not been determined. Intravascular ultrasound (IVUS) has shown that the decrease in arterial area is responsible for most of the late lumen loss in nonstented lesions and that intimal hyperplasia is responsible for all of the late lumen loss in stented lesions.
Methods and Results Serial (postintervention and follow-up at 5.6±3.3 months) IVUS was used to study 251 native coronary lesions in 241 patients; 63 patients had treated diabetes mellitus (oral hypoglycemic drugs or insulin). Interventional procedures included percutaneous transluminal coronary angioplasty, directional or rotational atherectomy, excimer laser angioplasty, or Palmaz-Schatz stents. The external elastic membrane (EEM), stent, and lumen areas were measured. The plaque+media (P+M) area in nonstented lesions was calculated as EEM minus lumen area, and the intimal hyperplasia (IH) area in stented lesions was calculated as stent minus lumen area. The anatomic slice selected for serial analysis had an axial location within the target lesion at the smallest follow-up lumen area. Nonstented lesions in diabetics and nondiabetics had a similar decrease in EEM cross-sectional area (CSA; 1.9±2.8 versus 1.8±4.2 mm2; P=.6350). However, nonstented lesions in diabetics had a greater increase in P=M CSA (1.3±2.8 versus 0.6±2.5 mm2, P=.0720), and the increase in P=M CSA contributed a greater percentage to the decrease in lumen CSA. In stented lesions, the decrease in lumen CSA (5.2±2.5 versus 2.0±2.3 mm2) and the increase in IH CSA (5.0±2.8 versus 1.8±2.0 mm2) were greater in diabetics than nondiabetics (P=.0009 and P=.0007, respectively). These findings were even more striking in (nonstented and stented) restenotic lesions.
Conclusions Serial IVUS analysis showed that the main reason for increased restenosis in diabetes mellitus was exaggerated intimal hyperplasia in both stented and nonstented lesions.
Key Words: diabetes mellitus • angioplasty • stents • remodeling • coronary disease
|
Introduction |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
Restenosis remains a major limitation to percutaneous coronary revascularization. Patients with diabetes mellitus have a greater incidence of restenosis, which is associated with increased late morbidity and mortality.1 2 Animal models, human necropsy studies, and analyses of retrieved atherectomy specimens originally suggested that an exaggeration of the normal reparative processes after angioplasty-induced local vessel trauma leads to uncontrolled smooth muscle cell proliferation and restenosis. Conversely, recent serial IVUS studies showed that arterial remodeling (the chronic decrease in arterial CSA) was responsible for most of the late lumen loss in nonstented lesions and that in-stent neointimal hyperplasia was responsible for all of the late lumen loss in stented lesions.3 4 The present study used IVUS to study the reason for exaggerated restenosis in diabetic patients.
|
Methods |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
Patient Population
From July 1991 to April 1996, serial (postintervention and follow-up at 5.6±3.3 months) IVUS and QCA were used to study 251 native coronary lesions in 241 patients. This was an inclusive series of patients studied after intervention and at follow-up for recurrent symptoms or as part of clinical protocols.
There were 149 men and 92 women (mean age, 58±11 years). On the basis of blinded independent chart review, 63 patients had treated diabetes mellitus (insulin or oral hypoglycemic drugs). Lesion location was left main (n=6), left anterior descending (n=104), left circumflex (n=37), and right coronary (n=104) arteries. Interventional procedures included PTCA (n=35), directional (n=111), or rotational (n=41) atherectomy; excimer laser angioplasty (n=24); or Palmaz-Schatz stents (n=40). Lesion location and patterns of device used were similar in diabetic and nondiabetic patients.
QCA Examination
All films were reviewed by individuals at a core angiographic laboratory who were blinded to the diabetes classification and IVUS results. With the use of an automated edge detection algorithm (ARTREK, Quantitative Cardiac Systems) and the outer diameter of contrast-filled catheters for calibration, MLD, reference diameter, and percent diameter stenosis were measured from multiple projections; the results in the "worst" view were recorded. Angiographic restenosis was defined as a follow-up percent diameter stenosis of 
50%.
IVUS Imaging
IVUS studies were performed using one of two systems. The first (InterTherapy Inc) incorporated a single-element 25-MHz transducer and an angled mirror mounted on the tip of a flexible shaft within a 3.9F short monorail imaging sheath. The second (CardioVascular Imaging Systems, Inc) used a single-element beveled transducer mounted on the tip of a flexible shaft within a 3.2F short monorail imaging sheath. With both systems, the transducer was rotated at 1800 rpm and withdrawn automatically at 0.5 mm/s. After intervention and at follow-up, 0.2 mg nitroglycerin IC was given, the IVUS catheter was advanced 5 to 10 mm distal to the lesion, and a complete imaging run was performed from beyond the lesion to the aorto-ostial junction with the motorized transducer pullback device. Studies were recorded on 1/2-in high-resolution super VHS tapes for off-line analysis.
Quantitative IVUS Analysis
With computerized planimetry, quantitative image analysis was performed by a single individual blinded to the QCA results and diabetes classification. By use of one or more reproducible axial landmarks (eg, aorto-ostial junction, side branches, or unusually shaped calcium deposits) and a known pullback speed, identical image slices could be identified for serial analysis. The image slice analyzed had an axial location within the target lesion at the smallest follow-up lumen CSA (rather than at the smallest postintervention lumen CSA). In practice, the follow-up study was analyzed first to identify the image slice with the smallest lumen; then, the distance from this image slice to the closest identifiable axial landmark was measured using seconds of videotape; finally, this distance was used to identify the corresponding image slice on the postintervention study. Vascular and perivascular markings were used to confirm image slice identification. If necessary, serial studies were analyzed side by side and imaging runs were studied frame by frame to ensure that the same image slice was measured.
Validation of cross-sectional measurements by IVUS and their use and reproducibility in assessing mechanisms of restenosis have been reported previously.3 4 5 6 In nonstented lesions, the EEM and lumen CSA were measured; P+M CSA was calculated as EEM minus lumen CSA. In stented lesions, stent and lumen CSA were measured. IH CSA was defined as stent minus lumen CSA. The EEM CSA (representing the area within the media-adventitia border) was a measure of total arterial CSA. Because IVUS cannot measure media thickness accurately, P+M CSA was used as a measure of plaque. When plaque encompassed the catheter, the lumen was assumed to be the physical, not acoustical, size of the imaging catheter.
Statistical Analysis
Statistical analysis was performed with Statview 4.02 (Abacus Concepts). Quantitative data are presented as mean±SD. Qualitative data are presented as frequencies. Categorical variables were compared by use of 
2 statistics and Fisher's exact test. Continuous variables were compared by use of paired and unpaired Student's t test.
|
Results |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
Serial QCA Results
The reference measured 2.81±0.51 mm. After intervention, the MLD increased from 0.91±0.48 to 2.45±0.59 mm (P<.0001); the percent diameter stenosis decreased from 68±16% to 16±14% (P<.0001). At follow-up, the MLD decreased to 1.48±0.89 mm; the percent diameter stenosis increased to 48±27% (both P<.0001 vs postintervention values); and 129 lesions (51%) were restenotic.
Serial IVUS Results in Nonstented Lesions
In nondiabetics, 78% of the decrease in lumen CSA (from 6.8±2.5 mm2 after intervention to 4.5±4.4 mm2 at follow-up, P<.0001) was the result of a decrease in EEM CSA (from 20.0±6.3 to 18.2±6.7 mm2, P<.0001); 22% was the result of an increase in P+M CSA (from 13.2±5.6 to 13.8±5.5 mm2, P=.0090). In diabetics, 59% of the decrease in lumen CSA (from 6.3±2.6 mm2 after intervention to 3.1±2.5 mm2 at follow-up, P<.0001) was the result of a decrease in EEM CSA (from 20.6±6.9 to 18.7±6.3 mm2, P<.0001); 41% was the result of an increase in P+M CSA (from 14.3±5.6 to 15.6±6.0 mm2, P=.0005). Diabetics and nondiabetics had a similar decrease in EEM CSA (see the Table
). However, treated diabetics had a greater increase in P+M CSA, and the increase in P+M CSA contributed a greater percentage to the decrease in lumen CSA. These findings were even more significant in restenotic lesions (see the Table and Figs 1 and 2).
|
|
|
Serial IVUS Results in Stented Lesions
All the decrease in lumen CSA at follow-up (from 8.0±2.4 to 2.8±2.7 mm2 in diabetics and from 7.3±2.9 to 5.3±3.2 mm2 in nondiabetics, both P<.0001) was the result of IH CSA (5.1±2.8 mm2 in diabetics and 2.1±2.0 mm2 in nondiabetics). The decrease in lumen CSA and the increase in IH CSA were greater in diabetics; as in nonstented lesions, these findings were even more striking in restenotic lesions (Table
).
|
Discussion |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
Diabetes is a consistent clinical predictor of restenosis after angioplasty and coronary stenting.1 2 7 8 Several studies have reported restenosis rates of 47% to 71% in diabetics.1 2 7 A recent analysis from the Bypass Angioplasty Revascularization Investigation trial8 showed worse 5-year survival rates in diabetics with multivessel disease treated by balloon angioplasty compared with those undergoing bypass surgery. Using QCA, Carrozza et al9 found that diabetics had a greater incidence of restenosis after stenting; this was attributed to greater in-stent IH.
With serial IVUS analysis, the current study found that in nonstented lesions, the decrease in EEM CSA was similar in diabetics and nondiabetics. However, the present study also found that in diabetics exaggerated tissue proliferation was superimposed on the decrease in EEM CSA in nonstented lesions. In diabetics, there was also exaggerated tissue proliferation in stented lesions. These findings were even more striking in restenotic lesions, whether stented or nonstented. Diabetes is associated with hormonal and vascular abnormalities that promote smooth muscle cell proliferation after vascular injury, including injury from catheter-based interventions.10 Increased smooth muscle proliferation in diabetics may result from mitogens (such as platelet-derived growth factor and insulinlike growth factor) that stimulate cell growth and deleterious vascular effects of endothelial dysfunction and excessive extracellular matrix production.10 11 12 13 14
Study Limitations
First, because this is a study of patients presenting for follow-up largely for symptomatic recurrence, it may represent a skewed population because of the nature of the follow-up. However, there was no bias toward performing follow-up studies in diabetic versus nondiabetic patients. Second, this study depended on accurate identification of the same anatomic section on serial studies (image slice with the smallest follow-up minimum lumen CSA). This precluded blinded IVUS analysis, may not have accurately reflected the serial changes in minimum lumen CSA, and potentially exaggerated the degree of both acute lumen CSA gain and loss. Third, differences in vascular tone could have contributed to change in lumen and EEM CSA. However, this should not have affected 
P+M CSA. Fourth, serial IVUS analysis can measure only net changes in P+M CSA. It cannot isolate the relative contributions of atherosclerosis progression/regression, cellular proliferation, matrix deposition, or plaque stabilization to the overall change in P+M CSA. Fifth, a heterogeneous diabetic population was studied; the number of insulin-dependent patients was too small for subset analysis.
Conclusions
In diabetic and nondiabetic patients, there was a similar decrease in EEM CSA; this contributed importantly to late lumen loss in nonstented lesions, especially in nondiabetics. In diabetic patients, however, there was exaggerated tissue proliferation, especially in restenotic lesions. This was seen in both stented and nonstented lesions and may explain the increased rate of restenosis in diabetes mellitus.
|
Selected Abbreviations and Acronyms |
|---|
|
|
Acknowledgments |
|---|
This study was supported in part by the Cardiology Research Foundation, Washington, DC.
Received November 21, 1996; revision received January 22, 1997; accepted January 23, 1997.
|
References |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
1. Stein B, Weintraub WS, Gebhart SSP, Cohen-Bernstein CL, Grosswald R, Liberman HA, Douglas JS, Morris DC, King SB III. Influence of diabetes mellitus on early and late outcome after percutaneous transmural coronary angioplasty. Circulation. 1995;91:979-989.
2.
Kip KE, Faxon DP, Detre KM, Yeh W, Kelsey SF, Curier JW. Coronary angioplasty in diabetic patients: the National Heart, Lung, and Blood Institute Percutaneous Transluminal Coronary Angioplasty Registry. Circulation. 1996;94:1818-1825.
3.
Mintz GS, Popma JJ, Pichard AD, Kent KM, Satler LF, Wong C, Hong MK, Kovach JA, Leon MB. Arterial remodeling after coronary angioplasty: a serial intravascular ultrasound study. Circulation. 1996;94:35-43.
4.
Hoffmann R, Mintz GS, Dussaillant GR, Popma JJ, Pichard AD, Satler LF, Kent KM, Griffin J, Leon MB. Patterns and mechanisms of instent restenosis: a serial intravascular ultrasound study. Circulation. 1996;94:1247-1254.
5. Gussenhoven EJ, Essed CE, Lancee CT, Mastik F, Frietman P, van Egmond FC, Reiber J, Bosch H, van Urk H, Roelandt J, Bom N. Arterial wall characteristics determined by intravascular ultrasound imaging: an in vitro study. J Am Coll Cardiol. 1989;14:947-952.[Abstract]
6. Nishimura RA, Edwards WD, Warnes CA, Reeder GS, Holmes DR Jr, Tajij AJ, Yock PG. Intravascular ultrasound imaging: in vitro validation and pathologic correlation. J Am Coll Cardiol. 1990;16:145-154.[Abstract]
7. Weintraub ES, Kosinski AS, Brown CL, King SB. Can restenosis after coronary angioplasty be predicted from clinical variables? J Am Coll Cardiol. 1993;21:6-14.[Abstract]
8.
Bypass Angioplasty Revascularization Investigation (BARI) Investigators. Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. N Engl J Med. 1996;335:217-225.
9.
Carrozza JP, Kuntz RE, Fishman RF, Baim DS. Restenosis after arterial injury caused by coronary stenting in patients with diabetes mellitus. Ann Intern Med. 1993;118:344-349.
10. Aronson D, Bloomgarden Z, Rayfield EJ. Potential mechanisms promoting restenosis in diabetic patients. J Am Coll Cardiol. 1996;27:528-535.[Abstract]
11. Kanzaki T, Shinomiya M, Ueda S, Morizaki N, Saito Y, Yoshida S. Enhanced arterial intimal thickening after balloon catheter injury in diabetic animals accompanied by PDGF ß-receptor overexpression. Eur J Clin Invest. 1994;24:377-381.[Medline] [Order article via Infotrieve]
12.
Stout RW, Bierman EL, Ross R. Effect of insulin on the proliferation of cultured primate arterial smooth muscle cell. Circ Res. 1975;36:319-327.
13. Bornfeldt KE, Raines EW, Nakano T, Graves TN, Krebs EG, Ross R. Insulin-like growth factor-1 and platelet derived growth factor-BB induce direct migration of human smooth muscle cells via signaling pathways that are distinct from those of proliferation. J Clin Invest. 1994;93:1266-1274.
14.
Kirstein M, Brett J, Radoff S, Ogawa S, Stern D, Vlassara H. Advanced protein glycosylation induces selective transendothelial human monocyte chemotaxis and secretion of PDGF: role in vascular disease in diabetes and aging. Proc Natl Acad Sci U S A. 1990;87:9010-9014.
This article has been cited by other articles:
 |
|
 |
|
  C. Jiang, H. Zhang, W. Zhang, W. Kong, Y. Zhu, H. Zhang, Q. Xu, Y. Li, and X. Wang Homocysteine promotes vascular smooth muscle cell migration by induction of the adipokine resistin Am J Physiol Cell Physiol, December 1, 2009; 297(6): C1466 - C1476. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. A. Tran, S. D. Barnett, S. L. Hunt, A. Chon, and N. Ad The effect of previous coronary artery stenting on short- and intermediate-term outcome after surgical revascularization in patients with diabetes mellitus. J. Thorac. Cardiovasc. Surg., August 1, 2009; 138(2): 316 - 323. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Takagi, H. Okura, Y. Kobayashi, T. Kataoka, H. Taguchi, I. Toda, K. Tamita, A. Yamamuro, Y. Sakanoue, A. Ito, et al. A Prospective, Multicenter, Randomized Trial to Assess Efficacy of Pioglitazone on In-Stent Neointimal Suppression in Type 2 Diabetes: POPPS (Prevention of In-Stent Neointimal Proliferation by Pioglitazone Study) J. Am. Coll. Cardiol. Intv., June 1, 2009; 2(6): 524 - 531. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Weisz, M. B. Leon, D. R. Holmes Jr, D. J. Kereiakes, J. J. Popma, P. S. Teirstein, S. A. Cohen, H. Wang, D. E. Cutlip, and J. W. Moses Five-year follow-up after sirolimus-eluting stent implantation results of the SIRIUS (Sirolimus-Eluting Stent in De-Novo Native Coronary Lesions) Trial. J. Am. Coll. Cardiol., April 28, 2009; 53(17): 1488 - 1497. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. B Lindsey, F. Cipollone, S. M Abdullah, and D. K Mcguire Receptor for advanced glycation end-products (RAGE) and soluble RAGE (sRAGE): cardiovascular implications Diabetes and Vascular Disease Research, January 1, 2009; 6(1): 7 - 14. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Garg, S.-L. T. Normand, T. S. Silbaugh, R. E. Wolf, K. Zelevinsky, A. Lovett, M. R. Varma, Z. Zhou, and L. Mauri Drug-Eluting or Bare-Metal Stenting in Patients With Diabetes Mellitus: Results From the Massachusetts Data Analysis Center Registry Circulation, November 25, 2008; 118(22): 2277 - 2285. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. O. Jensen, M. Maeng, P. Thayssen, E. H. Christiansen, K. N. Hansen, A. Galloe, H. Kelbaek, J. F. Lassen, and L. Thuesen Neointimal hyperplasia after sirolimus-eluting and paclitaxel-eluting stent implantation in diabetic patients: The Randomized Diabetes and Drug-Eluting Stent (DiabeDES) Intravascular Ultrasound Trial Eur. Heart J., November 2, 2008; 29(22): 2733 - 2741. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-W. Lee, S.-W. Park, Y.-H. Kim, S.-C. Yun, D.-W. Park, C. W. Lee, M.-K. Hong, K.-S. Rhee, J. K. Chae, J.-K. Ko, et al. A Randomized Comparison of Sirolimus- Versus Paclitaxel-Eluting Stent Implantation in Patients With Diabetes Mellitus J. Am. Coll. Cardiol., August 26, 2008; 52(9): 727 - 733. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Zhuang, Q. Pu, B. Ceacareanu, Y. Chang, M. Dixit, and A. Hassid Chronic insulin treatment amplifies PDGF-induced motility in differentiated aortic smooth muscle cells by suppressing the expression and function of PTP1B Am J Physiol Heart Circ Physiol, July 1, 2008; 295(1): H163 - H173. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Li, J. M. Sanders, M. H. Bevard, Z. Sun, J. W. Chumley, E. V. Galkina, K. Ley, and I. J. Sarembock CD40 Ligand Promotes Mac-1 Expression, Leukocyte Recruitment, and Neointima Formation after Vascular Injury Am. J. Pathol., April 1, 2008; 172(4): 1141 - 1152. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Billinger, J. Beutler, K. R. Taghetchian, A. Remondino, P. Wenaweser, S. Cook, M. Togni, C. Seiler, C. Stettler, F. R. Eberli, et al. Two-year clinical outcome after implantation of sirolimus-eluting and paclitaxel-eluting stents in diabetic patients Eur. Heart J., March 2, 2008; 29(6): 718 - 725. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. L. Brown, T. M. Sundt III, and B. J. Gersh Indications for Revascularization Card. Surg. Adult, January 1, 2008; 3(2008): 551 - 572. [Full Text]
|
|
|
|
 |
|
 B. You, A. Ren, G. Yan, and J. Sun Activation of Sphingosine Kinase-1 Mediates Inhibition of Vascular Smooth Muscle Cell Apoptosis by Hyperglycemia Diabetes, May 1, 2007; 56(5): 1445 - 1453. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Bruemmer C-Peptide in Insulin Resistance and Vascular Complications: Teaching an Old Dog New Tricks Circ. Res., November 24, 2006; 99(11): 1149 - 1151. [Full Text] [PDF]
|
|
|
|
|
|
D. Walcher, C. Babiak, P. Poletek, S. Rosenkranz, H. Bach, S. Betz, R. Durst, M. Grub, V. Hombach, J. Strong, et al. C-Peptide Induces Vascular Smooth Muscle Cell Proliferation: Involvement of Src-Kinase, Phosphatidylinositol 3-Kinase, and Extracellular Signal-Regulated Kinase 1/2 Circ. Res., November 24, 2006; 99(11): 1181 - 1187. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Saia, G. Piovaccari, A. Manari, A. Santarelli, A. Benassi, E. Aurier, P. Sangiorgio, F. Tarantino, G. Geraci, G. Vecchi, et al. Clinical Outcomes for Sirolimus-Eluting Stents and Polymer-Coated Paclitaxel-Eluting Stents in Daily Practice: Results From a Large Multicenter Registry J. Am. Coll. Cardiol., October 3, 2006; 48(7): 1312 - 1318. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. G. Cin, H. Pekdemir, M. N. Akkus, A. Camsari, O. Doven, and S. Yenihan Cutting Balloon Angioplasty for the Treatment of In-Stent Restenosis in Diabetics: A Matched Comparison of 6 Months' Outcome With Conventional Balloon Angioplasty Angiology, August 1, 2006; 57(4): 445 - 452. [Abstract] [PDF]
|
|
|
|
|
|
P. Jimenez-Quevedo, M. Sabate, D. J. Angiolillo, M. A. Costa, F. Alfonso, J. A. Gomez-Hospital, R. Hernandez-Antolin, C. Banuelos, J. Goicolea, F. Fernandez-Aviles, et al. Vascular Effects of Sirolimus-Eluting Versus Bare-Metal Stents in Diabetic Patients: Three-Dimensional Ultrasound Results of the Diabetes and Sirolimus-Eluting Stent (DIABETES) Trial J. Am. Coll. Cardiol., June 6, 2006; 47(11): 2172 - 2179. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Wu, K. Kathir, P. K. Witting, K. Beck, K. Choy, C. Li, K. D. Croft, T. A. Mori, D. Tanous, M. R. Adams, et al. Antioxidants protect from atherosclerosis by a heme oxygenase-1 pathway that is independent of free radical scavenging J. Exp. Med., April 17, 2006; 203(4): 1117 - 1127. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. De Luca, H. Suryapranata, J. Timmer, J. P. Ottervanger, A. W.J. van't Hof, J. C.A. Hoorntje, J.-H. Dambrink, A.T. M. Gosselink, and M.-J. de Boer Impact of Routine Stenting on Clinical Outcome in Diabetic Patients Undergoing Primary Angioplasty for ST-Segment Elevation Myocardial Infarction Diabetes Care, April 1, 2006; 29(4): 920 - 923. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Pei, J. Gu, P.-R. Thimmalapura, A. Mison, and J. L. Nadler Activation of the 12-lipoxygenase and signal transducer and activator of transcription pathway during neointima formation in a model of the metabolic syndrome Am J Physiol Endocrinol Metab, January 1, 2006; 290(1): E92 - E102. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. K. Jagadeesha, T. E. Lindley, J. DeLeon, R. V. Sharma, F. Miller, and R. C. Bhalla Tempol therapy attenuates medial smooth muscle cell apoptosis and neointima formation after balloon catheter injury in carotid artery of diabetic rats Am J Physiol Heart Circ Physiol, September 1, 2005; 289(3): H1047 - H1053. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E. Barbato, B. S. Zuckerbraun, M. Overhaus, K. G. Raman, and E. Tzeng Nitric oxide modulates vascular inflammation and intimal hyperplasia in insulin resistance and the metabolic syndrome Am J Physiol Heart Circ Physiol, July 1, 2005; 289(1): H228 - H236. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. B. Hermiller, A. Raizner, L. Cannon, P. A. Gurbel, M. A. Kutcher, S. C. Wong, M. E. Russell, S. G. Ellis, R. Mehran, G. W. Stone, et al. Outcomes with the polymer-based paclitaxel-eluting TAXUS stent in patients with diabetes mellitus: The TAXUS-IV trial J. Am. Coll. Cardiol., April 19, 2005; 45(8): 1172 - 1179. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Nishimatsu, E. Suzuki, H. Satonaka, R. Takeda, M. Omata, T. Fujita, R. Nagai, T. Kitamura, and Y. Hirata Endothelial dysfunction and hypercontractility of vascular myocytes are ameliorated by fluvastatin in obese Zucker rats Am J Physiol Heart Circ Physiol, April 1, 2005; 288(4): H1770 - H1776. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Takeda, E. Suzuki, H. Satonaka, S. Oba, H. Nishimatsu, M. Omata, T. Fujita, R. Nagai, and Y. Hirata Blockade of Endogenous Cytokines Mitigates Neointimal Formation in Obese Zucker Rats Circulation, March 22, 2005; 111(11): 1398 - 1406. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Redondo, E. Ruiz, C. G. Santos-Gallego, E. Padilla, and T. Tejerina Pioglitazone Induces Vascular Smooth Muscle Cell Apoptosis Through a Peroxisome Proliferator-Activated Receptor-{gamma}, Transforming Growth Factor-{beta}1, and a Smad2-Dependent Mechanism Diabetes, March 1, 2005; 54(3): 811 - 817. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Calabro, I. Samudio, J. T. Willerson, and E. T.H. Yeh Resistin Promotes Smooth Muscle Cell Proliferation Through Activation of Extracellular Signal-Regulated Kinase 1/2 and Phosphatidylinositol 3-Kinase Pathways Circulation, November 23, 2004; 110(21): 3335 - 3340. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Choi, S.-K. Kim, S.-H. Choi, Y.-G. Ko, C.-W. Ahn, Y. Jang, S.-K. Lim, H.-C. Lee, and B.-S. Cha Preventative Effects of Rosiglitazone on Restenosis After Coronary Stent Implantation in Patients With Type 2 Diabetes Diabetes Care, November 1, 2004; 27(11): 2654 - 2660. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.-K. Yip, C.-J. Wu, C.-H. Yang, H.-W. Chang, S.-M. Chen, W.-C. Hung, and C.-L. Hang Delayed Post-Myocardial Infarction Invasive Measures, Helpful or Harmful?: A Subgroup Analysis Chest, July 1, 2004; 126(1): 38 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Mehran, G. D. Dangas, Y. Kobayashi, A. J. Lansky, G. S. Mintz, E. D. Aymong, M. Fahy, J. W. Moses, G. W. Stone, and M. B. Leon Short- and long-term results after multivessel stenting in diabetic patients J. Am. Coll. Cardiol., April 21, 2004; 43(8): 1348 - 1354. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. M.G. Legrand, P. W. Serruys, F. Unger, B. A. van Hout, M. C.M. Vrolix, G. M.P. Fransen, T. T. Nielsen, P. K. Paulsen, R. S. Gomes, J. M.G. de Queiroz e Melo, et al. Three-Year Outcome After Coronary Stenting Versus Bypass Surgery for the Treatment of Multivessel Disease Circulation, March 9, 2004; 109(9): 1114 - 1120. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Chaves, A. G.M.R. Sousa, L. A. Mattos, A. Abizaid, R. Staico, F. Feres, M. Centemero, L. F. Tanajura, A. Abizaid, I. Pinto, et al. 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 Circulation, February 24, 2004; 109(7): 861 - 866. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. A. Corpus, P. B. George, J. A. House, S. R. Dixon, S. C. Ajluni, W. H. Devlin, G. C. Timmis, M. Balasubramaniam, and W. W. O'Neill Optimal glycemic control is associated with a lower rate of target vessel revascularization in treated type II diabetic patients undergoing elective percutaneous coronary intervention J. Am. Coll. Cardiol., January 7, 2004; 43(1): 8 - 14. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Kornowski and S. Fuchs Optimization of glycemic control and restenosis prevention in diabetic patients undergoing percutaneous coronary interventions J. Am. Coll. Cardiol., January 7, 2004; 43(1): 15 - 17. [Full Text] [PDF]
|
|
|
|
|
|
A. Abizaid, M. A. Costa, D. Blanchard, M. Albertal, H. Eltchaninoff, G. Guagliumi, L. Geert-Jan, A. S. Abizaid, A. G.M.R. Sousa, E. Wuelfert, et al. Sirolimus-eluting stents inhibit neointimal hyperplasia in diabetic patients: Insights from the RAVEL Trial Eur. Heart J., January 2, 2004; 25(2): 107 - 112. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Degertekin, P. A. Lemos, C. H. Lee, K. Tanabe, J.E. Sousa, A. Abizaid, E. Regar, G. Sianos, W. J. van der Giessen, P. J. de Feyter, et al. Intravascular ultrasound evaluation after sirolimus eluting stent implantation for de novo and in-stent restenosis lesions Eur. Heart J., January 1, 2004; 25(1): 32 - 38. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. T. Hurst and R. W. Lee Increased Incidence of Coronary Atherosclerosis in Type 2 Diabetes Mellitus: Mechanisms and Management Ann Intern Med, November 18, 2003; 139(10): 824 - 834. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Stephenson, J. Tunstead, A. Tsai, R. Gordon, S. Henderson, and H. M. Dansky Neointimal Formation After Endovascular Arterial Injury Is Markedly Attenuated in db/db Mice Arterioscler Thromb Vasc Biol, November 1, 2003; 23(11): 2027 - 2033. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K.-H. Mak and D. P. Faxon Clinical studies on coronary revascularization in patients with type 2 diabetes Eur. Heart J., June 2, 2003; 24(12): 1087 - 1103. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. T. de Dios, D. Bruemmer, R. J. Dilley, M. E. Ivey, G. L.R. Jennings, R. E. Law, and P. J. Little Inhibitory Activity of Clinical Thiazolidinedione Peroxisome Proliferator Activating Receptor-{gamma} Ligands Toward Internal Mammary Artery, Radial Artery, and Saphenous Vein Smooth Muscle Cell Proliferation Circulation, May 27, 2003; 107(20): 2548 - 2550. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. O. Costantini, A. J. Lansky, G. S. Mintz, K. Shirai, G. Dangas, R. Mehran, M. Fahy, S. Slack, M. Coral, P. S. Teirstein, et al. Intravascular brachytherapy for native coronary ostial in-stent restenotic lesions J. Am. Coll. Cardiol., May 21, 2003; 41(10): 1725 - 1731. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Zhou, K. Wang, M. S. Penn, S. P. Marso, M. A. Lauer, F. Forudi, X. Zhou, W. Qu, Y. Lu, D. M. Stern, et al. Receptor for AGE (RAGE) Mediates Neointimal Formation in Response to Arterial Injury Circulation, May 6, 2003; 107(17): 2238 - 2243. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. E. Sobel, R. Frye, and K. M. Detre Burgeoning Dilemmas in the Management of Diabetes and Cardiovascular Disease: Rationale for the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Trial Circulation, February 4, 2003; 107(4): 636 - 642. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. M. Sundt III, B. J. Gersh, and H. C. Smith Indications for Coronary Revascularization Card. Surg. Adult, January 1, 2003; 2(2003): 541 - 559. [Full Text]
|
|
|
|
|
|
T. Kataoka, E. Grube, Y. Honda, Y. Morino, S.-H. Hur, H. N. Bonneau, A. Colombo, C. Di Mario, G. Guagliumi, K. E. Hauptmann, et al. 7-Hexanoyltaxol-Eluting Stent for Prevention of Neointimal Growth: An Intravascular Ultrasound Analysis From the Study to COmpare REstenosis rate between QueST and QuaDS-QP2 (SCORE) Circulation, October 1, 2002; 106(14): 1788 - 1793. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Van Belle, M. Perie, D. Braune, A. Chmait, T. Meurice, K. Abolmaali, E. P. McFadden, C. Bauters, J.-M. Lablanche, and M. E. Bertrand effects of coronary stenting on vessel patency and long-term clinical outcome after percutaneous coronary revascularization in diabetic patients J. Am. Coll. Cardiol., August 7, 2002; 40(3): 410 - 417. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Mathew and D. R. Holmes Outcomes in diabetics undergoing revascularization: The long and the short of it J. Am. Coll. Cardiol., August 7, 2002; 40(3): 424 - 427. [Full Text] [PDF]
|
|
|
|
|
|
M.J. Sampson, I.R. Davies, J.C. Brown, K. Ivory, and D.A. Hughes Monocyte and Neutrophil Adhesion Molecule Expression During Acute Hyperglycemia and After Antioxidant Treatment in Type 2 Diabetes and Control Patients Arterioscler Thromb Vasc Biol, July 1, 2002; 22(7): 1187 - 1193. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Gruberg, R. Waksman, A. E. Ajani, H.-S. Kim, R. L. White, E. E. Pinnow, L. F. Satler, A. D. Pichard, K. M. Kent, and J. Lindsay Jr The effect of intracoronary radiation for the treatment of recurrent in-stent restenosis in patients with diabetes mellitus J. Am. Coll. Cardiol., June 19, 2002; 39(12): 1930 - 1936. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Roffi, D. J. Moliterno, B. Meier, E. R. Powers, C. L. Grines, P. M. DiBattiste, H. C. Herrmann, M. Bertrand, K. E. Harris, L. A. Demopoulos, et al. Impact of Different Platelet Glycoprotein IIb/IIIa Receptor Inhibitors Among Diabetic Patients Undergoing Percutaneous Coronary Intervention: Do Tirofiban and ReoPro Give Similar Efficacy Outcomes Trial (TARGET) 1-Year Follow-Up Circulation, June 11, 2002; 105(23): 2730 - 2736. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. R. Sindermann, J. Smith, C. Kobbert, G. Plenz, A. Skaletz-Rorowski, J. L. Solomon, L. Fan, and K. L. March Direct evidence for the importance of p130 in injury response and arterial remodeling following carotid artery ligation Cardiovasc Res, June 1, 2002; 54(3): 676 - 683. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Smith Jr, D. Faxon, W. Cascio, H. Schaff, T. Gardner, A. Jacobs, S. Nissen, and R. Stouffer Prevention Conference VI: Diabetes and Cardiovascular Disease: Writing Group VI: Revascularization in Diabetic Patients Circulation, May 7, 2002; 105 (18): e165 - e169. [Full Text] [PDF]
|
|
|
|
|
|
H. Alfke, J. J. Froelich, S. Nowak, and H.-J. Wagner Cardiovascular Risk Factors Do Not Predict Clinically Defined Restenosis After Percutaneous Transluminal Angioplasty for Lower Limb Ischemia Angiology, January 1, 2002; 53(1): 15 - 20. [Abstract] [PDF]
|
|
|
|
|
|
H. V. Anderson, J. McNatt, F. J. Clubb, M. Herman, J.-P. Maffrand, F. DeClerck, C. Ahn, L. M. Buja, and J. T. Willerson Platelet Inhibition Reduces Cyclic Flow Variations and Neointimal Proliferation in Normal and Hypercholesterolemic-Atherosclerotic Canine Coronary Arteries Circulation, November 6, 2001; 104(19): 2331 - 2337. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. G. Demaria, S. Fortier, M. Carrier, and L. P. Perrault Early multifocal stenosis after coronary artery snaring during off-pump coronary artery bypass in a patient with diabetes J. Thorac. Cardiovasc. Surg., November 1, 2001; 122(5): 1044 - 1045. [Full Text] [PDF]
|
|
|
|
|
|
N. Mercado, E. Boersma, W. Wijns, B. J. Gersh, C. A. Morillo, V. de Valk, G.-A. van Es, D. E. Grobbee, and P. W. Serruys Clinical and quantitative coronary angiographic predictors of coronary restenosis: A comparative analysis from the balloon-to-stent era J. Am. Coll. Cardiol., September 1, 2001; 38(3): 645 - 652. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Adamian, A. Colombo, C. Briguori, T. Nishida, F. Marsico, C. Di Mario, R. Albiero, I. Moussa, and J. W. Moses Cutting balloon angioplasty for the treatment of in-stent restenosis: a matched comparison with rotational atherectomy, additional stent implantation and balloon angioplasty J. Am. Coll. Cardiol., September 1, 2001; 38(3): 672 - 679. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Ahmed, G. S. Mintz, R. Waksman, R. Mehran, B. Leiboff, A. D. Pichard, L. F. Satler, K. M. Kent, and N. J. Weissman Serial Intravascular Ultrasound Assessment of the Efficacy of Intracoronary {gamma}-Radiation Therapy for Preventing Recurrence in Very Long, Diffuse, In-Stent Restenosis Lesions Circulation, August 21, 2001; 104(8): 856 - 859. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-H. Park, S. P. Marso, Z. Zhou, F. Foroudi, E. J. Topol, and A. M. Lincoff Neointimal Hyperplasia After Arterial Injury Is Increased in a Rat Model of Non-Insulin-Dependent Diabetes Mellitus Circulation, August 14, 2001; 104(7): 815 - 819. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Abizaid, M. A. Costa, M. Centemero, A. S. Abizaid, V. M.G. Legrand, R. V. Limet, G. Schuler, F. W. Mohr, W. Lindeboom, A. G.M.R. Sousa, et al. Clinical and Economic Impact of Diabetes Mellitus on Percutaneous and Surgical Treatment of Multivessel Coronary Disease Patients: Insights From the Arterial Revascularization Therapy Study (ARTS) Trial Circulation, July 31, 2001; 104(5): 533 - 538. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Indolfi, D. Torella, L. Cavuto, A. M. Davalli, C. Coppola, G. Esposito, M. V. Carriero, A. Rapacciuolo, E. Di Lorenzo, E. Stabile, et al. Effects of Balloon Injury on Neointimal Hyperplasia in Streptozotocin-Induced Diabetes and in Hyperinsulinemic Nondiabetic Pancreatic Islet-Transplanted Rats Circulation, June 19, 2001; 103(24): 2980 - 2986. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Moustapha, A. R. Assali, S. Sdringola, W. K. Vaughn, R. D. Fish, O. Rosales, G. Schroth, Z. Krajcer, R. W. Smalling, and H. V. Anderson Percutaneous and surgical interventions for in-stent restenosis: long-term outcomes and effect of diabetes mellitus J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1877 - 1882. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Ledru, P. Ducimetiere, S. Battaglia, D. Courbon, F. Beverelli, L. Guize, J.-L.e. Guermonprez, and B. Diebold New diagnostic criteria for diabetes and coronary artery disease: insights from an angiographic study J. Am. Coll. Cardiol., May 1, 2001; 37(6): 1543 - 1550. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Hall, J. C. Chatham, H. Eldar-Finkelman, and G. H. Gibbons Upregulation of Glucose Metabolism During Intimal Lesion Formation Is Coupled to the Inhibition of Vascular Smooth Muscle Cell Apoptosis: Role of GSK3{beta} Diabetes, May 1, 2001; 50(5): 1171 - 1179. [Abstract] [Full Text]
|
|
|
|
|
|
M. Nakamura, P. G. Yock, H. N. Bonneau, K. Kitamura, T. Aizawa, H. Tamai, P. J. Fitzgerald, and Y. Honda Impact of Peri-Stent Remodeling on Restenosis : A Volumetric Intravascular Ultrasound Study Circulation, May 1, 2001; 103(17): 2130 - 2132. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Matsa, Y. Paz, J. Gurevitch, I. Shapira, A. Kramer, D. Pevny, and R. Mohr Bilateral skeletonized internal thoracic artery grafts in patients with diabetes mellitus J. Thorac. Cardiovasc. Surg., April 1, 2001; 121(4): 668 - 674. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. A. Hsueh, S. Jackson, and R. E. Law Control of Vascular Cell Proliferation and Migration by PPAR-{gamma}: A new approach to the macrovascular complications of diabetes Diabetes Care, February 1, 2001; 24(2): 392 - 397. [Abstract] [Full Text]
|
|
|
|
|
|
A. Endo, H. Hirayama, O. Yoshida, T. Arakawa, T. Akima, T. Yamada, and M. Nanasato Arterial remodeling influences the development of intimal hyperplasia after stent implantation J. Am. Coll. Cardiol., January 1, 2001; 37(1): 70 - 75. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Takagi, T. Akasaka, A. Yamamuro, Y. Honda, T. Hozumi, S. Morioka, and K. Yoshida Troglitazone reduces neointimal tissue proliferation after coronary stent implantation in patients with non-insulin dependent diabetes mellitus: A serial intravascular ultrasound study J. Am. Coll. Cardiol., November 1, 2000; 36(5): 1529 - 1535. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Hall, C. M. Matter, X. Wang, and G. H. Gibbons Hyperglycemia Inhibits Vascular Smooth Muscle Cell Apoptosis Through a Protein Kinase C-Dependent Pathway Circ. Res., September 29, 2000; 87(7): 574 - 580. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Takagi, K. Yoshida, T. Akasaka, S. Kaji, T. Kawamoto, Y. Honda, A. Yamamuro, T. Hozumi, and S. Morioka Hyperinsulinemia during oral glucose tolerance test is associated with increased neointimal tissue proliferation after coronary stent implantation in nondiabetic patients: A serial intravascular ultrasound study J. Am. Coll. Cardiol., September 1, 2000; 36(3): 731 - 738. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Chajara, M. Raoudi, B. Delpech, M. Leroy, J. P. Basuyau, and H. Levesque Increased Hyaluronan and Hyaluronidase Production and Hyaluronan Degradation in Injured Aorta of Insulin-Resistant Rats Arterioscler Thromb Vasc Biol, June 1, 2000; 20(6): 1480 - 1487. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Hasdai, C. B. Granger, S. S. Srivatsa, D. A. Criger, S. G. Ellis, R. M. Califf, E. J. Topol, and D. R. Holmes Jr. Diabetes mellitus and outcome after primary coronary angioplasty for acute myocardial infarction: lessons from the GUSTO-IIb angioplasty substudy J. Am. Coll. Cardiol., May 1, 2000; 35(6): 1502 - 1512. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Schofer, M. Schluter, T. Rau, F. Hammer, N. Haag, and D. G. Mathey Influence of treatment modality on angiographic outcome after coronary stenting in diabetic patients: a controlled study J. Am. Coll. Cardiol., May 1, 2000; 35(6): 1554 - 1559. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Gyongyosi, P. Yang, A. Khorsand, D. Glogar, on behalf of the Austrian Wiktor Stent Study Group, and European Paragon Stent Investigators Longitudinal straightening effect of stents is an additional predictor for major adverse cardiac events J. Am. Coll. Cardiol., May 1, 2000; 35(6): 1580 - 1589. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Indolfi, A. Cioppa, E. Stabile, E. Di Lorenzo, G. Esposito, A. Pisani, A. Leccia, L. Cavuto, A. M. Stingone, A. Chieffo, et al. Effects of hydroxymethylglutaryl coenzyme A reductase inhibitor simvastatin on smooth muscle cell proliferation in vitro and neointimal formation in vivo after vascular injury J. Am. Coll. Cardiol., January 1, 2000; 35(1): 214 - 221. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. Marso, A. M. Lincoff, S. G. Ellis, D. L. Bhatt, J.-F. Tanguay, N. S. Kleiman, T. Hammoud, J. E. Booth, S. K. Sapp, and E. J. Topol Optimizing the Percutaneous Interventional Outcomes for Patients With Diabetes Mellitus : Results of the EPISTENT (Evaluation of Platelet IIb/IIIa Inhibitor for Stenting Trial) Diabetic Substudy Circulation, December 21, 1999; 100(25): 2477 - 2484. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. R. Moreno, J. T. Fallon, A. M. Murcia, M. N. Leon, H. Simosa, V. Fuster, and I. F. Palacios Tissue characteristics of restenosis after percutaneous transluminal coronary angioplasty in diabetic patients J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1045 - 1049. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Taylor, A. P. Burke, A. Farb, P. Yousefi, G. T. Malcom, J. Smialek, and R. Virmani Arterial remodeling in the left coronary system: The role of high-density lipoprotein cholesterol J. Am. Coll. Cardiol., September 1, 1999; 34(3): 760 - 767. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Van Belle, K. Abolmaali, C. Bauters, E. P. McFadden, J.-M. Lablanche, and M. E. Bertrand Restenosis, late vessel occlusion and left ventricular function six months after balloon angioplasty in diabetic patients J. Am. Coll. Cardiol., August 1, 1999; 34(2): 476 - 485. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Lincoff, R. M. Califf, D. J. Moliterno, S. G. Ellis, J. Ducas, J. H. Kramer, N. S. Kleiman, E. A. Cohen, J. E. Booth, S. K. Sapp, et al. Complementary Clinical Benefits of Coronary-Artery Stenting and Blockade of Platelet Glycoprotein IIb/IIIa Receptors N. Engl. J. Med., July 29, 1999; 341(5): 319 - 327. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Elezi, A. Kastrati, J.u. Pache, A. Wehinger, M. Hadamitzky, J. Dirschinger, F.-J. Neumann, and A. Schomig Diabetes mellitus and the clinical and angiographic outcome after coronary stent placement J. Am. Coll. Cardiol., December 1, 1998; 32(7): 1866 - 1873. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. de Vrey, G. S. Mintz, C. von Birgelen, T. Kimura, M. Noboyoshi, J. J. Popma, P. W. Serruys, and M. B. Leon Serial volumetric (three-dimensional) intravascular ultrasound analysis of restenosis after directional coronary atherectomy J. Am. Coll. Cardiol., December 1, 1998; 32(7): 1874 - 1880. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Sousa Uva, E. Braunberger, M. Fisher, Y. Fromes, P. H. Deleuze, J. A. Celestin, and O. M. Bical Does bilateral internal thoracic artery grafting increase surgical risk in diabetic patients? Ann. Thorac. Surg., December 1, 1998; 66(6): 2051 - 2055. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Nishimoto, Y. Miyazaki, Y. Toki, R. Murakami, M. Shinoda, A. Fukushima, and H. Kanayama Enhanced secretion of insulin plays a role in the development of atherosclerosis and restenosis of coronary arteries: elective percutaneous transluminal coronary angioplasty in patients with effort angina J. Am. Coll. Cardiol., November 15, 1998; 32(6): 1624 - 1629. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Elezi, A. Kastrati, F.-J. Neumann, M. Hadamitzky, J. Dirschinger, and A. Schomig Vessel Size and Long-Term Outcome After Coronary Stent Placement Circulation, November 3, 1998; 98(18): 1875 - 1880. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Abizaid, R. Kornowski, G. S. Mintz, M. K. Hong, A. S. Abizaid, R. Mehran, A. D. Pichard, K. M. Kent, L. F. Satler, H. Wu, et al. The influence of diabetes mellitus on acute and late clinical outcomes following coronary stent implantation J. Am. Coll. Cardiol., September 1, 1998; 32(3): 584 - 589. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Lansky, G. S. Mintz, J. J. Popma, A. D. Pichard, K. M. Kent, L. F. Satler, D. S. Baim, R. E. Kuntz, C. Simonton, R. M. Bersin, et al. Remodeling after directional coronary atherectomy (with and without adjunct percutaneous transluminal coronary angioplasty): a serial angiographic and intravascular ultrasound analysis from the optimal atherectomy restenosis study J. Am. Coll. Cardiol., August 1, 1998; 32(2): 329 - 337. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. G. Ellis and C. R. Narins Problem of Angioplasty in Diabetics Circulation, September 16, 1997; 96(6): 1707 - 1710. [Full Text]
|
|
|
|
|
|
S. Uemura, H. Matsushita, W. Li, A. J. Glassford, T. Asagami, K.-H. Lee, D. G. Harrison, and P. S. Tsao Diabetes Mellitus Enhances Vascular Matrix Metalloproteinase Activity : Role of Oxidative Stress Circ. Res., June 22, 2001; 88(12): 1291 - 1298. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. E. Kip, E. L. Alderman, M. G. Bourassa, M. M. Brooks, L. Schwartz, D. R. Holmes Jr, R. M. Califf, P. L. Whitlow, B. R. Chaitman, and K. M. Detre Differential Influence of Diabetes Mellitus on Increased Jeopardized Myocardium After Initial Angioplasty or Bypass Surgery: Bypass Angioplasty Revascularization Investigation Circulation, April 23, 2002; 105(16): 1914 - 1920. [Abstract] [Full Text] [PDF]
|
|
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||