(Circulation. 1997;96:1454-1460.)
© 1997 American Heart Association, Inc.
Articles |
Restenosis Rates in Diabetic Patients
A Comparison of Coronary Stenting and Balloon Angioplasty in Native Coronary Vessels
From the Department of Cardiology, University of Lille, France.
Correspondence to Michel E. Bertrand, MD, Service de Cardiologie B, Hôpital Cardiologique, Boulevard du Professeur J. Leclercq, 59037 Lille Cedex, France. E-mail bertrandme{at}aol.com
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Abstract |
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Background Diabetes is a major risk factor for restenosis after coronary balloon angioplasty. Recent studies have shown that coronary stenting significantly reduces restenosis compared with balloon angioplasty alone. However, limited information is available on the effect of coronary stenting in diabetic patients.
Methods and Results We designed this study to analyze the effect of diabetes on restenosis in patients treated with either balloon angioplasty or coronary stenting who were enrolled in a 6-month angiographic follow-up program. Three hundred consecutive patients, 19% of whom were diabetics, who underwent coronary stent implantation during a single-vessel procedure on native coronary vessels and who had 6-month angiographic follow-up constituted the study group (stent group). Three hundred consecutive patients who underwent 6-month angiographic follow-up after single-vessel conventional balloon angioplasty served as control patients (balloon group). Preprocedural, postprocedural, and follow-up angiograms were analyzed with quantitative angiography. In the balloon group, the restenosis rate was almost twofold higher in diabetic than in nondiabetic patients (63% versus 36%; P=.0002) owing to both a greater late loss (0.79±0.70 versus 0.41±0.61 mm, respectively; P<.0001) and a higher rate of late vessel occlusion (14% versus 3%, respectively; P<.001). In the stent group, restenosis rates were similar in diabetics and nondiabetics (25% versus 27%, respectively). Furthermore, in the stent group, late loss (0.77±0.65 versus 0.79±0.57 mm, respectively) and the rate of late vessel occlusion (2% versus 1%, respectively) did not differ significantly between diabetic and nondiabetic patients.
Conclusions Although diabetics have increased rates of restenosis and late vessel occlusion after simple balloon angioplasty, they have the same improved outcome with coronary stenting that has been documented in nondiabetic patients.
Key Words: diabetes mellitus • angioplasty • stents • restenosis
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Introduction |
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Coronary artery disease is frequently encountered in diabetic patients.1 2 Revascularization may be accomplished in such patients either by CABG or by PTCA. Recently, a report from the BARI study comparing CABG and PTCA in patients with multivessel disease showed that the mortality rate of diabetic patients treated by PTCA was almost two times higher than that of patients randomized to CABG. In contrast, the mortality rate of nondiabetic patients was similar whether they were treated by PTCA or CABG.3 Furthermore, it has been shown that diabetic patients have a higher rate of post-PTCA restenosis4 5 6 7 8 ; this has been suggested to reflect a higher propensity to develop neointimal hyperplasia.9
Intracoronary stent implantation has been shown to significantly reduce angiographic restenosis in humans10 11 ; the better long-term angiographic result is due to a better acute result and to the prevention of chronic remodeling despite an increase in neointimal hyperplasia.12 It is unclear if these favorable results may be extended to diabetic patients.
We therefore designed the present study to analyze the effect of coronary stenting in diabetic patients. Angiographic restenosis rates were compared between diabetic and nondiabetic patients undergoing coronary stenting or conventional balloon angioplasty.
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Methods |
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Study Population
From the records of our catheterization laboratory, we identified 300 consecutive patients who underwent 6-month angiographic follow-up after successful stent implantation during a single-vessel PTCA procedure on a native coronary vessel performed between April 1994 and March 1996 (stent group). As routinely performed in our institution,13 14 15 these patients were enrolled in a 6-month angiographic follow-up program: all patients were asked at the time of the initial procedure to return for a 6-month follow-up angiogram regardless of symptomatic status; an angiography could be performed earlier if there was clinical indication. During the above study period, the rate of 6-month angiographic follow-up was 83%; this rate was similar in diabetic (83%) and nondiabetic patients (82%).
Three hundred consecutive patients with 6-month angiographic follow-up after successful single-vessel conventional balloon angioplasty between March 1993 and April 1995 served as control patients (balloon group). As described above, during this period an angiographic follow-up was proposed to all patients at the time of balloon angioplasty. Angiographic follow-up was actually obtained in 82% of the patients, and the rate of follow-up was similar in diabetic (82%) and nondiabetic patients (81%). Patients in the latter group were included in an ongoing prospective study of genetic risk factors for restenosis. Angiographic and clinical data concerning some of the control patients have been reported previously.16 17
Diabetes Mellitus and Treatment: Definitions
At the time of the initial procedure, patients were classified
as diabetic if they were treated by oral hypoglycemic drugs or insulin
or if they had a previous history, documented on their medical chart,
of elevated (
140 mg/dL) fasting blood glucose on at least two
separate occasions in conjunction with adhering to ongoing dietary
measures to control their glucose level.
Diabetic patients were classified in three categories depending on antidiabetic management at the time of the initial procedure: (1) diet alone, (2) oral hypoglycemic drugs (diet and oral hypoglycemic drugs but no insulin), and (3) insulin (irrespective of other therapy).
Angioplasty Procedure
Balloon angioplasty and coronary stenting were performed
according to the standard technique in our laboratory.18
All patients received aspirin 300 mg/d; a bolus dose of heparin
(10 000 IU) was administered just before PTCA. In patients who
underwent coronary stenting, treatment with ticlopidine (500
mg) was started immediately after the procedure. In both groups of
patients, when the procedure was performed in the morning, no heparin
was administered after the procedure, and the introducer sheath was
removed when the effects of heparin had worn off. When the procedure
was performed in the afternoon, 1000 IU/h heparin was infused until 6
AM the next day, and the sheath was removed later that
morning.18 The procedure was considered successful when
the residual luminal narrowing in the dilated segment immediately after
angioplasty was <50% and when no major complication (ECG or enzymatic
evidence of myocardial infarction, the need for bypass surgery during
hospitalization, or in-hospital death) occurred. In terms of
antithrombotic treatment at discharge, the patients who underwent
conventional balloon angioplasty received aspirin alone, whereas the
patients who had coronary stent implantation received a
combination of aspirin (325 mg) and ticlopidine (500 mg) daily for 6
weeks and then aspirin alone.
Qualitative Angiographic Analyses
The qualitative analyses were performed independently by
two experienced interventional cardiologists. Disagreements were
resolved by a further joint reading.
The anterograde blood flow was graded using the classification of the TIMI study group.19
The reasons for stent placement were classified in three categories: (1) bailout implantation (for acute or threatened acute occlusion during or after the procedure), (2) implantation for a suboptimal result, or (3) elective implantation. Acute closure was defined as vessel occlusion with TIMI grade 1 or 0 flow, based on the appearance of the vessel immediately before stent insertion. Threatened closure was defined as the presence of a significant dissection immediately after angioplasty (more severe than grade B according to the American Heart Association/American College of Cardiology classification20 ) associated with a reduction in flow in the vessel or with ECG evidence of myocardial ischemia. A suboptimal result was defined as the presence of a visually estimated residual stenosis >40% after dilatation with or without an associated nonocclusive dissection (grade A or B) but with normal blood flow (TIMI grade 3). Implantation was classified as elective when it had been decided before the procedure.
Quantitative Coronary Angiography
Quantitative computer-assisted angiographic measurements
were performed on end-diastolic frames with use of the
CAESAR (Computer-Assisted Evaluation of Stenosis and
Restenosis) system. A detailed description of this system has
been reported previously.21 We routinely perform
angiography in at least two projections after the
intracoronary injection of isosorbide dinitrate (2 mg). These
projections are recorded in our database, and after injection
of isosorbide dinitrate, the follow-up angiogram is performed in the
same projections. The following definitions were used: the acute
gain associated with the procedure was defined as the difference
between the MLD immediately after stent implantation and the MLD before
the procedure; the late loss during the follow-up period was defined as
the difference between the MLD immediately after stent implantation and
the MLD at follow-up; the net gain was defined as the difference
between the acute gain and the late loss; and finally, to define
restenosis, we used a categorical approach with the classic
criterion of >50% stenosis at follow-up.
Statistical Analysis
Data are presented as mean±SD. For continuous
variables, comparisons between two groups were made with the
Student t test, whereas comparisons between more than two
groups were made with ANOVA followed by Scheffé's F
test. Differences between proportions were assessed by
2 analysis. A value of P<.05
was considered to indicate statistical significance.
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Results |
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The baseline characteristics of the study population are shown in Table 1
. Most of the 600 patients were
male (84%), with a mean age of 59±11 years. Thirty-three percent of
the patients had unstable angina, and 33% had experienced a recent
(<1 month previous) myocardial infarction. The incidence of diabetes
was the same in the balloon group (19%) and the stent group (19%).
There were no statistically significant differences in baseline
characteristics between diabetic and nondiabetic patients in either
group except for hypertension, which was more frequent in diabetic
patients (P<.01). In the stent group, stenting was
attempted for bailout in 13%, for a suboptimal result after
conventional balloon angioplasty in 69%, and electively in 18% of the
patients. Most of the patients underwent implantation of a
Palmaz-Schatz stent (66%). In 81%, a single stent was used.
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Angiographic Outcome in the Balloon Angioplasty Group
The results of quantitative angiography in the balloon group
are shown in Table 2, and cumulative
curves are illustrated in the top panel of the
Figure. There were no significant
differences in reference diameter between diabetic and nondiabetic
patients at any of the three time points studied (before the procedure,
after the procedure, and at 6-month follow-up). The MLD before and
after the procedure did not differ significantly between the two
groups. At follow-up angiography, the MLD was significantly
(P<.0001) smaller and the percent diameter stenosis
was significantly (P<.0001) greater in diabetic patients
than in nondiabetic patients. The late loss during the
follow-up period was almost twofold greater (P<.0001) in
diabetic patients (0.79±0.70 mm) than in nondiabetic patients
(0.41±0.61 mm). The net gain was significantly
(P<.0001) higher in nondiabetic patients (0.75±0.67
mm) than in diabetic patients (0.36±0.74 mm). As analyzed
by the categorical approach using the >50% diameter stenosis
criterion, 63% of diabetic patients had restenosis compared
with 36% of nondiabetic patients (P=.0002).
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In the balloon group, total occlusion of the dilated site at follow-up
occurred in 3% of nondiabetic patients but in 14% of diabetic
patients (P=.001; Table 2
). When patients with total
occlusion at follow-up were excluded from the analysis, late
loss was still significantly higher and MLD at follow-up significantly
smaller in diabetic than in nondiabetic patients (late loss: 0.63±0.60
versus 0.37±0.54 mm, P=.003; MLD at follow-up:
1.37±0.65 versus 1.63±0.59 mm, P=.006).
In diabetic patients, a trend toward a worse angiographic outcome was
observed in patients treated with insulin (80% restenosis
rate) that did not reach statistical significance (Table 4).
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Angiographic Outcome in the Coronary Stent Group
The results of quantitative angiography in the stent group
are shown in Table 3, and cumulative
curves are presented in the bottom panel of the Figure. As in
the balloon group, there were no significant differences in reference
diameter or stenosis severity before and after the procedure
between diabetic and nondiabetic patients. At follow-up angiography,
stenosis severity (MLD, percent diameter stenosis) was
similar in both groups. The late loss and the net gain were also
similar in both groups (diabetic patients: late loss=0.77±0.65
mm, net gain=1.00±0.70 mm; nondiabetic patients: late
loss=0.79±0.57 mm, net gain=0.98±0.72 mm). Twenty-five
percent of diabetic patients had restenosis (>50% diameter
stenosis at follow-up) versus 27% of nondiabetic patients
(P=NS).
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In the stent group, total occlusion of the dilated site at follow-up
occurred in 1% of nondiabetic and 2% of diabetic patients
(P=NS; Table 3). Because the overall frequency of total
occlusion at follow-up was low in the stent group, the results were not
modified when those patients were excluded from the analysis
(data not shown).
Within the group of diabetic patients, the angiographic outcome was
similar in the three subgroups (Table 4).
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Discussion |
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The present study demonstrates that despite similar baseline characteristics, diabetic patients who underwent balloon angioplasty had a much higher risk of restenosis than nondiabetic patients also treated by balloon angioplasty. The immediate result of angioplasty (acute gain) was not affected by diabetes; the increased risk of restenosis was related both to a greater degree of late luminal loss during the follow-up period and to the more frequent occurrence of total vessel occlusion. By contrast, in the group of patients undergoing coronary stenting, the presence of diabetes was not associated with a greater risk of restenosis, as demonstrated by the quantitative angiographic results summarized in Table 3
. The 25% rate of restenosis after coronary
stenting in diabetic patients compares favorably with the 63% rate
observed in otherwise comparable patients after conventional balloon
angioplasty. This demonstrates that coronary stenting is
associated with a significant improvement in midterm angiographic
follow-up in diabetic patients.
Diabetes Mellitus as a Risk Factor for Restenosis After
Balloon Angioplasty
Previous studies have shown that diabetes is an independent risk
factor for restenosis after balloon angioplasty, with reported
restenosis rates ranging from 47% to 69%.4 5 6 7 8 Our
study is consistent with these reports, showing an increased
restenosis rate in diabetic patients treated with balloon
angioplasty (63%). This prohibitive rate of restenosis may be
one of the reasons for the poor clinical outcome recently reported in
diabetic patients treated with balloon
angioplasty.3 22
Diabetes Is Not a Risk Factor for Restenosis After
Coronary Stenting
Two recent randomized trials have demonstrated that
coronary stent implantation may decrease the risk of
restenosis10 11 ; however, limited and conflicting
results are available on the effect of diabetes on restenosis
after coronary stenting.23 24 25 26 The results of the
present study, demonstrating that the presence of diabetes is not
associated with an increased risk of restenosis after
coronary stenting, extend the results of previous reports in
which diabetes was not found to be a risk factor for in-stent
restenosis.23 26 These results are not in
accordance with a report by Carroza et al24 that
demonstrated an increased rate of restenosis in diabetic
patients after stenting. This discrepancy may be related to the fact
that in the study by Carroza et al,24 most of the diabetic
patients underwent stent implantation at saphenous vein graft lesions,
whereas the present study was restricted to procedures performed in
native vessels.
Mechanisms of Restenosis in Diabetic Patients
The exact mechanisms responsible for the increased
restenosis rate after conventional balloon angioplasty in
diabetic patients are unknown. It has been suggested that the
prothrombotic milieu present in diabetic coronary vessels,
including increased blood viscosity, increased fibrinogen and factor
VIII levels, a decrease in the biological activity of antithrombin III,
and enhanced platelet aggregation, could play a role in this
phenomenon.27 28 29 Previous studies demonstrating that
thrombus is both more frequently associated with coronary
lesions in diabetic patients30 and is a predictor of late
vessel occlusion after angioplasty,15 as well as a study
by Rensing et al4 showing that diabetes was a risk factor
for late vessel occlusion, are consistent with this hypothesis.
Our results demonstrating a fourfold increase in the occlusion rate at
follow-up in diabetic patients lend further support to this hypothesis.
The analysis of restenosis rates performed after
exclusion of the patients with total occlusion at follow-up suggests,
however, that late vessel occlusion is not the sole explanation for the
increased restenosis rate in diabetic patients and that other
mechanisms may be involved.
It has also been suggested that the degree of neointimal hyperplasia might be greater as a consequence of a stimulatory effect of growth factors such as insulin-like growth factor-1 on vascular smooth muscle cells.9 However, recent experimental31 32 33 and clinical34 studies have demonstrated that the contribution of neointimal hyperplasia to restenosis after balloon angioplasty is relatively limited and that lumen renarrowing is in fact mostly related to vessel remodeling (ie, chronic sclerosis with vessel constriction). Although further studies will be needed to directly address this question, a preliminary study by Murcia et al35 has shown that the specific feature of atherectomy specimens from restenotic lesions retrieved in diabetic patients was not an enhanced smooth muscle proliferation but rather a greater fibrotic response that may lead to vessel constriction.
The present results provide new insights into the mechanisms involved in restenosis in diabetic patients. Indeed, because the stent prevents the remodeling process, restenosis after coronary stenting is mainly the consequence of neointimal hyperplasia within the stent.12 Thus, factors that directly affect the degree of neointimal hyperplasia would be more likely to influence restenosis after coronary stenting than restenosis after balloon angioplasty. Our results showing that diabetes is a major risk factor for restenosis after balloon angioplasty but not after coronary stenting do not support the hypothesis that there is a greater degree of neointimal hyperplasia in diabetics but rather favor the hypothesis that diabetes may affect the remodeling process.
In addition, in the patients treated by stenting, diabetes was not associated with an increased risk of late vessel occlusion. Considering the high rate of late coronary occlusion in diabetic patients treated with balloon angioplasty, this suggests that in addition to its favorable effect on vascular remodeling, coronary stenting may also be effective in preventing late vessel occlusion. The potential mechanisms of the reduction in vessel reocclusion by coronary stenting are unclear. However, if we consider that the presence of a protruding thrombus as assessed by angioscopy at the balloon angioplasty site is a strong predictor of late vessel occlusion,15 it is likely that the mechanical effect of a coronary stent, by consolidation of the plaque and isolation of the lumen from all materials including thrombus present at the surface of the vessel, is the main reason for this favorable effect. The combination of two potent antiplatelet agents, aspirin and ticlopidine, systematically used after stent implantation in the present study is another possible explanation for this effect.18 36
Antidiabetic Regimen and Restenosis
To the best of our knowledge, no information is available on the
importance of the type of diabetes as a risk factor for
restenosis. The results of the present study suggest that
patients requiring insulin therapy have the worst angiographic outcome
after balloon angioplasty; however, due to the small size of the
insulin group, these results need to be interpreted with caution. A
larger prospective study is needed to address this issue.
Limitations
Potential study limitations need to be addressed. First, this was
not a randomized study. However, it was a relatively large series of
consecutive patients with similar baseline characteristics enrolled
prospectively in a 6-month angiographic follow-up program. Second, most
of the patients in the stent group were not treated electively but
rather because there was a suboptimal result after balloon angioplasty
or as a bailout procedure. However, bailout coronary stenting
has usually been associated with high restenosis
rates,37 and one might expect an even better 6-month
angiographic outcome if coronary stenting had been performed
electively. Finally, this study focused on the 6-month angiographic
follow-up and does not provide information on the clinical outcome.
Conclusions
Our study confirms that balloon angioplasty in diabetics is
associated with a prohibitive rate of restenosis and that this
technique of revascularization may not be the most
appropriate technique to treat coronary artery disease in such
patients. Diabetes, however, does not affect the restenosis
rate when coronary stenting is performed. Furthermore, the
lower restenosis rate in diabetic patients treated by stenting
versus those treated by balloon angioplasty suggests that
coronary stenting could significantly reduce restenosis
in this subset of patients. This last issue will need to be validated
by randomized trials focused on diabetic patients.
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Selected Abbreviations and Acronyms |
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Received January 20, 1997; revision received March 17, 1997; accepted April 13, 1997.
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References |
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|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
1. Hambly RI, Sherman L, Mehta J, Aintablian A. Reappraisal of the role of the diabetic state in coronary artery disease. Chest. 1976;70:251-257.
2. Frein FS, Scheuer J. Heart disease in diabetes. In: Rifkin H, Porte D Jr, eds. Ellenberg and Rifkin's Diabetes Mellitus Theory and Practice. New York, NY: Elsevier Science Publishing Corp; 1990:812-823.
3.
Alderman EL, Andrews K, Bost J, Bourassa M, Chaitman
BR, Detre K, Faxon DP, Follman D, Frye RL, Hlatky M, Jones RH, Kelsey
SF, Rogers WJ, Rosen AD, Hartzell S, Sellers MA, Sopko G, Sutton Tyrell
K, Williams DO. Comparison of coronary bypass surgery
with angioplasty in patients with multivessel disease.
N Engl J Med. 1996;335:217-225.
4.
Rensing BJ, Hermans WRM, Vos J, Tijssen JGP, Rutch W,
Danchin N, Heyndrickx GR, Mast EG, Wijns W, Serruys PW, on behalf of
the Coronary Artery Restenosis Prevention on Repeated
Thromboxane Antagonism (CARPORT) Study Group. Luminal narrowing
after percutaneous transluminal coronary
angioplasty: a study of clinical, procedural, and lesional factors
related to long-term angiographic outcome. Circulation. 1993;88:975-985.
5. Holmes DR Jr, Vlietstra RE, Smith HC, Vetrovec GW, Kent KM, Cowley MJ, Faxon DP, Gruentzig AR, Kelsey SF, Detre KM, Van Raden MJ, Mock MB. Restenosis after percutaneous transluminal coronary angioplasty (PTCA): a report from the PTCA Registry of the National Heart, Lung, and Blood Institute. Am J Cardiol. 1984;53:77C-81C.[Medline] [Order article via Infotrieve]
6. Weintraub WS, 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]
7. Quigley PJ, Hlatky MA, Hinohara T, Rendall DS, Perez JA, Phillips HR, Califf RM, Stack RS. Repeat percutaneous transluminal coronary angioplasty and predictors of recurrent restenosis. Am J Cardiol. 1989;63:409-413.[Medline] [Order article via Infotrieve]
8. Lambert M, Bonan R, Côté G, Crépeau J, De Guise P, Lespérance J, David PR, Waters DD. Multiple coronary angioplasty: a model to discriminate systemic and procedural factors related to restenosis. J Am Coll Cardiol. 1988;12:310-314.[Abstract]
9. Aronson D, Bloomgarden Z, Rayfield EJ. Potential mechanisms promoting restenosis in diabetic patients. J Am Coll Cardiol. 1996;27:528-535.[Abstract]
10.
Fischman DL, Leon MB, Baim DS, Schatz RA, Savage MP,
Penn I, Detre K, Veltri L, Ricci D, Nobuyoshi M, Cleman M, Heuser R,
Almond D, Teirstein PS, Fish RD, Colombo A, Brinker J, Moses J,
Shaknovich A, Hirshfeld J, Bailey S, Ellis S, Rake R, Goldberg
S. A randomized comparison of coronary-stent placement
and balloon angioplasty in the treatment of coronary artery
disease. N Engl J Med. 1994;331:496-501.
11.
Serruys PW, de Jaegere P, Kiemeneij F, Macaya C, Rutsch
W, Heyndrickx G, Emanuelsson H, Marco J, Legrand V, Materne P, Belardi
J, Sigwart U, Colombo A, Goy JJ, Van Den Heuvel P, Delcan J, Morel
M-A. A comparison of balloon-expandable-stent implantation with
balloon angioplasty in patients with coronary artery
disease. N Engl J Med. 1994;331:489-495.
12.
Hoffmann R, Mintz GS, Dussaillant GR, Popma JJ, Pichard
AD, Satler LL, Kent KM, Griffin J, Leon MB. Patterns and
mechanisms of in-stent restenosis: a serial intravascular
ultrasound study. Circulation. 1996;94:1247-1254.
13.
Bauters C, McFadden EP, Lablanche JM, Quandalle P,
Bertrand ME. Restenosis rate after multiple
percutaneous transluminal coronary angioplasty
procedures at the same site: a quantitative angiographic study in
consecutive patients undergoing a third angioplasty for a second
restenosis. Circulation. 1993;88:969-974.
14.
Bauters C, Khanoyan P, McFadden EP, Quandalle P,
Lablanche JM, Bertrand ME. Restenosis after delayed
coronary angioplasty of the culprit vessel in patients with a
recent myocardial infarction treated by
thrombolysis. Circulation. 1995;91:1410-1418.
15.
Bauters C, Lablanche JM, McFadden EP, Hamon M, Bertrand
ME. Relation of coronary angioscopic findings at
coronary angioplasty to angiographic
restenosis. Circulation. 1995;92:2473-2479.
16.
Hamon M, Bauters C, Amant C, McFadden EP, Helbecque N,
Lablanche JM, Bertrand ME, Amouyel P. Relation between the
deletion polymorphism of the angiotensin-converting
enzyme gene and late luminal narrowing after coronary
angioplasty. Circulation. 1995;92:296-299.
17. Hamon M, Amant C, Bauters C, Lablanche JM, Bertrand ME, Amouyel P. ACE polymorphism, a genetic predictor of occlusion after coronary angioplasty. Am J Cardiol. 1996;78:679-681.[Medline] [Order article via Infotrieve]
18.
Lablanche JM, McFadden EP, Bonnet JL, Grollier G,
Danchin N, Bedossa M, Leclercq C, Vahanian A, Bauters C, Van Belle E,
Bertrand ME. Combined antiplatelet therapy with ticlopidine
and aspirin: a simplified approach to intracoronary stent
management. Eur Heart J. 1996;17:1373-1380.
19. The Thrombolysis In Myocardial Infarction (TIMI) Study Group. The Thrombolysis In Myocardial Infarction (TIMI) Trial. N Engl J Med. 1985;312:932-936.[Medline] [Order article via Infotrieve]
20. Ryan TJ, Faxon DP, Gunnar RM, Kennedy JW, King SB III, Loop FD, Peterson KL, Reeves TJ, Williams DO, Winters WL. Guidelines for percutaneous transluminal coronary angioplasty: a report of the AHA/ACC Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Subcommittee on Percutaneous Transluminal Coronary Angioplasty). J Am Coll Cardiol. 1988;12:529-545.[Medline] [Order article via Infotrieve]
21. Bertrand ME, Lablanche JM, Bauters C, Leroy F, McFadden EP. Discordant results of visual and quantitative estimates of stenosis severity before and after coronary angioplasty. Cathet Cardiovasc Diagn. 1993;28:1-6.[Medline] [Order article via Infotrieve]
22.
Kip KE, Faxon DP, Detre KM, Yeh W, Kelsey SF, Currier
JW, for the investigators of the NHLBI PTCA Registry. Coronary
angioplasty in diabetic patients: the National Heart, Lung, and Blood
Institute Percutaneous Transluminal Coronary
Angioplasty Registry. Circulation. 1996;94:1818-1825.
23. Foley JB, Penn IM, Brown RIG, Murray-Parsons N, White J, Galligan L, MacDonald C. Safety, success, and restenosis after elective coronary implantation of the Palmaz-Schatz stent in 100 patients at a single center. Am Heart J. 1993;125:686-694.[Medline] [Order article via Infotrieve]
24.
Carroza JP Jr, 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.
25.
Hearn JA, King SB III, Douglas JS Jr, Carlin SF, Lembo
NJ, Ghazzal MB. Clinical and angiographic outcomes after
coronary stenting for acute or threatened closure after
percutaneous transluminal coronary angioplasty:
initial results with a balloon-expandable, stainless steel
design. Circulation. 1993;88:2086-2096.
26.
Ellis SG, Savage M, Fischman D, Baim DS, Leon M,
Goldberg S, Hirshfeld JW, Cleman MW, Teirstein PS, Walker C, Bailey S,
Buchbinder M, Topol EJ, Schatz RA. Restenosis after
placement of Palmaz-Schatz stents in native coronary
arteries. Circulation. 1992;86:1836-1844.
27. MacRury S, Lowe G. Blood rheology in diabetes mellitus. Diabet Med. 1990;7:285-291.[Medline] [Order article via Infotrieve]
28. Ostermann H, van der Loo J. Factors of the hemostatic system in diabetic patients. Haemostasis. 1986;16:386-416.[Medline] [Order article via Infotrieve]
29. Davi G, Catalano I, Averna M, Notobartolo A, Stano A, Ciabottoni G. Thromboxane biosynthesis and platelet function in type II diabetes mellitus. N Engl J Med. 1990;322:1769-1774.[Abstract]
30. Silva JA, Escobar A, Collins TJ, Ramee SR, White CJ. Unstable angina: a comparison of angioscopic findings between diabetic and nondiabetic patients. J Am Coll Cardiol. 1995;92:1731-1736.
31.
Lafont A, Guzman LA, Whitlow PL, Goormastic M, Cornhill
JF, Chisolm GM. Restenosis after experimental
angioplasty: intimal, medial, and adventitial changes associated with
constrictive remodeling. Circ Res. 1995;76:996-1002.
32.
Kakuta T, Currier JW, Haudenschild CC, Ryan TJ, Faxon
DP. Differences in compensatory vessel enlargement, not intimal
formation, account for restenosis after angioplasty in the
hypercholesterolemic rabbit model.
Circulation. 1994;89:2809-2815.
33.
Post MJ, Borst C, Kuntz RE. The relative
importance of arterial remodeling compared with intimal
hyperplasia in lumen renarrowing after balloon angioplasty: a study in
the normal rabbit and in the hypercholesterolemic
Yucatan micropig. Circulation. 1994;89:2816-2821.
34.
Mintz GS, Popma JJ, Pichard AD, Kent SM, Satler LF,
Wong SC, Hong MK, Kovach JA, Leon MB. Arterial
remodeling after coronary angioplasty: a serial intravascular
ultrasound study. Circulation. 1996;94:35-43.
35. Murcia AM, Fallon JT, Fuster V. Smooth muscle cell proliferation does not account for restenosis in diabetic patients. Circulation. 1996;94(suppl I):I-619. Abstract.
36.
Schomig A, Neuman FJ, Kastrati A, Schühlen
H, Blasini R, Hadamitzky M, Walter H, Zitzmann-Roth EM, Richardt G, Alt
E, Schmitt C, Ulm K. A randomized comparison of antiplatelet
and anticoagulant therapy after the placement of coronary
artery stents. N Engl J Med. 1996;334:1084-1089.
37. Foley JB, Brown RIG, Penn IM. Thrombosis and restenosis after stenting in failed angioplasty: comparison with elective stenting. Am Heart J. 1994;128:12-20.[Medline] [Order article via Infotrieve]
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|
|
|
|
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|
|
|
|
|
|
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|
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|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
 R. Y. L. Zee, A. Fernandez-Ortiz, C. Macaya, E. Pintor, K. Lindpaintner, and A. Fernandez-Cruz ACE D/I Polymorphism and Incidence of Post-PTCA Restenosis : A Prospective, Angiography-Based Evaluation Hypertension, March 1, 2001; 37(3): 851 - 855. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
F. Ribichini, G. Steffenino, A. Dellavalle, A. Vado, V. Ferrero, T. Camilla, S. Giubergia, and E. Uslenghi Plasma Lipoprotein(a) Is Not a Predictor for Restenosis After Elective High-Pressure Coronary Stenting Circulation, September 22, 1998; 98(12): 1172 - 1177. [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]
|
|
|
|
 |
|
 Diabetics Also Benefit From Stents Journal Watch Cardiology, September 18, 1997; 1997(918): 5 - 5. [Full Text]
|
|
|
|
|
|
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