Abstract 17519: Diabetes Does Not Influence Long-Term Coverage on Top of the Everolimus-Eluting Bioresorbable Vascular Scaffold: A Longitudinal Porcine Optical Coherence Tomography Study
Diabetes mellitus (DM) remains a risk factor for restenosis after percutaneous coronary intervention despite the success of drug eluting stents. Whether DM also affects the vascular response to resorbable scaffolds is unknown. We evaluated the effect of DM on tissue coverage area at 3 and 6 months (M) following placement of Absorb BVS in a high cholesterol swine model. Based on literature, our hypothesis is that DM will result in more tissue coverage in response to Absorb BVS compared to non-DM (NDM).
DM was induced in 8 male farmbred swine by a single dose injection of 140 mg/kg streptozotocin. Two weeks after DM induction, a high-cholesterol diet was started in all 8 DM and 7 NDM swine. Nine months after start of the study, 32 Absorb BVS were randomly implanted with an intended S/A ratio of 1.1:1 under QCA and OCT guidance in 2 of 3 main epicardial arteries. All swine were followed for 3M (n=10 BVS) or 6M (n=22 BVS). Histological analysis was performed on a subset of 5 scaffolds at 3M (DM n=2, NDM n=3) and 10 scaffolds at 6M (DM n=5, NDM n=5). By OCT we measured coverage area and by histology we documented inflammatory and injury scores.
DM did not result in a greater coverage area 6M post Absorb BVS implantation (4.30±0.6 DM vs 4.05±0.5 NDM; P=NS). At 3M, coverage area was slightly higher in DM than NDM swine (4.42±0.5 vs 3.93±0.6 mm2; P=0.02). Histology showed minor inflammation in all coronary arteries at 3 and 6M, with a trend towards a higher score at 3M in DM compared to NDM (0.95±0.4 DM vs 0.31±0.26 NDM; P=0.08). This difference is however most likely caused by the higher injury score in the DM swine at 3M (1.3±0.4 DM vs 1.1±0.1 NDM; P=NS). There was no difference in inflammation score 6M post-implantation between DM (0.2±0.3) and NDM swine (0.3±0.5; P=NS). Similarly, injury scores were comparable at 6M (1.11±0.2 DM and 1.04±0.4 NDM; P=NS).
In conclusion, diabetes mellitus does not influence long-term coverage on top of the Absorb BVS in atherosclerotic swine (fig.1)
- © 2013 by American Heart Association, Inc.