Favorable effect of gamma-radiation for in-stent restenosis: effect of diabetes on angiographic and clinical outcomes.
The purpose of this study was to examine the effect of vascular brachytherapy with gamma-radiation (gamma-RT) in patients with diabetes mellitus (DM) with coronary in-stent restenosis (ISR). In the Washington Radiation for In-Stent Restenosis (WRIST) trial, 130 patients with ISR were treated with (192)Ir or placebo. Of the patients enrolled, 44 (34%) had DM (18 of them treated with gamma-RT and 26 with placebo). Gamma-radiation therapy of ISR in diabetics resulted in similar procedural success and in-hospital outcome compared to nondiabetics. At 6-month follow-up, both DM and non-DM patients treated with gamma-RT had significantly lower target lesion revascularization (TLR), target vessel revascularization, and major adverse cardiac event rates compared to placebo. DM remains a powerful predictor of TLR and major adverse cardiac events even after treatment of ISR with gamma-RT.
Iakovou
Ioannis
I
Cardiovascular Research Foundation, Lenox Hill Heart and Vascular Institute, New York, New York, USA.
Mehran
Roxana
R
Dangas
George
G
Lansky
Alexandra J
AJ
Stone
Gregg W
GW
Mintz
Gary S
GS
Aymong
Eve
E
Ashby
Dale T
DT
Pichard
Augusto D
AD
Satler
Lowell F
LF
Kent
Kenneth
K
Leon
Martin B
MB
Waksman
Ron
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D016009:Chi-Square Distribution; D002932:Cineangiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D015607:Stents; D016896:Treatment Outcome
D007496:Iridium Radioisotopes