title: Comparison of everolimus- versus paclitaxel-eluting stents implanted in patients with diabetes mellitus as evaluated by three-dimensional intravascular ultrasound analysis.
abstract: Previous reports have shown the advantage of paclitaxel compared to limus-derivative drugs for the treatment of diabetics. A total of 109 diabetics (115 lesions) treated with everolimus-eluting stents (EESs, n = 58) or paclitaxel-eluting stents (PESs, n = 55) undergoing 8 to 9 months of follow-up 3-dimensional intravascular ultrasound examinations were enrolled. In addition to the standard intravascular ultrasound parameters, the percentage of neointimal volume (neointimal volume/stent volume) and maximum percentage of cross-sectional narrowing (neointimal area/stent area) was calculated. EESs showed a lower percentage of neointimal volume (7.2 +/- 7.1% vs 11.7 +/- 11.0%; p = 0.01) and maximum percentage of cross-sectional narrowing (22.5 +/- 16.3% vs 29.4 +/- 19.2%; p = 0.04) than PESs. One case of severe narrowing (lesions with maximum percentage of cross-sectional narrowing >60%) in the EES group developed and 6 cases in the PESs group (p = 0.05). The EESs showed no serial changes for vessel or peri-stent plaque during the follow-up period, and PESs showed significant increases in vessel and peri-stent plaque. PESs showed significantly greater peri-stent plaque increase, with a tendency toward greater vessel enlargement than EESs. Late acquired incomplete stent apposition was observed in 2 PES cases. The major adverse cardiac event rate was comparable < or =2 years. In conclusion, EESs showed greater neointimal suppression without significant vessel expansion than PESs in diabetic patients. In this small cohort, no significant differences were observed in the major adverse cardiac event rate < or =2 years.
authors.affiliation: Center for Cardiovascular Technology, Stanford University, Stanford, CA, USA.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Otake
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
authors.forename: Masao
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Ichizo
authors.initials: I
authors.lastname: Tsujino
authors.forename: Takao
authors.initials: T
authors.lastname: Shimohama
authors.forename: Takao
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Ryota
authors.initials: R
authors.lastname: Sakurai
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Waseda
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Honda
authors.forename: Poornima
authors.initials: P
authors.lastname: Sood
authors.forename: Krishnankutty
authors.initials: K
authors.lastname: Sudhir
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Fitzgerald
mesh_terms: D000368:Aged; D023921:Coronary Stenosis / Q000150:complications / Q000628:therapy*; D048909:Diabetes Complications; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018084:Ultrasonography, Interventional
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D017239:Paclitaxel; D020123:Sirolimus