Increased incidence of coronary in-stent restenosis in type 2 diabetic patients is related to elevated serum malondialdehyde-modified low-density lipoprotein.
BACKGROUND
Type 2 diabetes mellitus (T2DM) has been reported as a major risk factor for in-stent restenosis (ISR) after intracoronary stenting, although the details of the mechanisms remain undefined. The aim of present study was to investigate the diabetes-related risk factor for ISR.


RESULTS
A total of 131 patients who were implanted with bare metal stent(s) were enrolled in this study. Based on follow-up coronary angiography at 6 months after stenting, the patients were classified according to the presence or absence of ISR. Various coronary risk factors, including serum malondialdehyde-modified low-density lipoprotein (MDA-LDL) levels, were investigated at follow-up angiogram to relate to ISR in patients with or without T2DM. The increased incidence of ISR was observed in diabetic patients, which was significantly related to the increased serum MDA-LDL concentrations. The serum MDA-LDL concentration was positively correlated to glycohemoglobin levels in diabetic patients. In addition, MDA-LDL concentration was not altered after the treatment of ISR.


CONCLUSIONS
The elevated serum MDA-LDL level is considered to be a potent risk factor for ISR in diabetic patients. MDA-LDL, which might be a consequence of metabolic abnormalities caused by diabetes, may act as a growth factor for neointimal tissues inside the implanted stent.
Shigematsu
Sakuji
S
Department of Cardiology, National Hospital Organization Beppu Medical Center, Beppu, Japan. sshige@med.oita-u.ac.jp
Takahashi
Naohiko
N
Hara
Masahide
M
Yoshimatsu
Hironobu
H
Saikawa
Tetsunori
T
D000368:Aged; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000209:etiology* / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008315:Malondialdehyde / Q000031:analogs & derivatives* / Q000097:blood; D008875:Middle Aged; D012307:Risk Factors; D015607:Stents; D017539:Tunica Intima / Q000473:pathology
D015415:Biomarkers; D008077:Lipoproteins, LDL; C502964:malondialdehyde-low density lipoprotein, mouse; D008315:Malondialdehyde