title: Soluble receptor for advanced glycation end products  is associated with in-stent restenosis in patients with  type 2 diabetes with drug-eluting coronary stents.
abstract: BACKGROUND
  The levels of soluble receptor for advanced glycation end products (sRAGE) may reflect the activity of the advanced glycation end products-RAGE axis, which has been proposed as a potential mechanism of vascular inflammation in patients with type 2 diabetes (T2D). However, the role of sRAGE in in-stent restenosis (ISR) is not yet known in patients with T2D with drug-eluting stent (DES) implantation.
  
  
  RESULTS
  We enrolled 35 patients with T2D with ISR (T2D-ISR) and 35 patients with age-matched T2D without ISR (T2D-control) at the time of follow-up coronary angiography after DES implantation. Plasma levels of glycosylated hemoglobin (HbA(1c)), C-reactive protein (CRP), insulin-like growth factor-1 (IGF-1), and sRAGE were measured in blood samples obtained at the time of the index procedure. Baseline characteristics showed no difference between the groups. Plasma levels of sRAGE were significantly higher in the T2D-ISR group than in the T2D-control group (7.29 ± 2.91 vs. 5.36 ± 2.20 ng/ml, P= 0.003), but levels of HbA(1c) (7.65 ± 1.59% vs. 7.60 ± 1.65%, P = 0.89), CRP (8.15 ± 13.82 vs. 5.59 ± 7.68 mg/l, P = 0.34), and IGF-1 (0.93 ± 0.37 vs. 0.99 ± 0.30 ng/ml, P = 0.42) did not differ significantly between the two study groups. In multivariate logistic regression analysis, elevated plasma level of sRAGE (above the median) was a significant predictor of ISR [odds ratio (OR): 4.33, 95% confidence interval (CI): 1.38–13.59, P = 0.01], followed by mean stent diameter less than 3.0mm (OR: 3.35, CI: 0.98–11.46, P = 0.05).
  
  
  CONCLUSIONS
  Plasma level of sRAGE may be positively associated with ISR and RAGE-dependent inflammatory responses may contribute more to ISR development than IGF-1-dependent proliferative responses in patients with T2D with DES implantation.
authors.affiliation: Department of Cardiology, College of Medicine, Seoul St Mary's Hospital, Seoul, Korea.
authors.forename: Hun-Jun
authors.initials: HJ
authors.lastname: Park
authors.forename: Suk Min
authors.initials: SM
authors.lastname: Seo
authors.forename: Woo Seung
authors.initials: WS
authors.lastname: Shin
authors.forename: Hee-Yeol
authors.initials: HY
authors.lastname: Kim
authors.forename: Yoon Seok
authors.initials: YS
authors.lastname: Choi
authors.forename: Yoon Seok
authors.initials: YS
authors.lastname: Koh
authors.forename: Sung-Gyu
authors.initials: SG
authors.lastname: Youn
authors.forename: Mahn Won
authors.initials: MW
authors.lastname: Park
authors.forename: Kiyuk
authors.initials: K
authors.lastname: Chang
authors.forename: Pum Joon
authors.initials: PJ
authors.lastname: Kim
authors.forename: Hae-Ok
authors.initials: HO
authors.lastname: Jung
authors.forename: Sang Hong
authors.initials: SH
authors.lastname: Baek
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Ki-Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Ki-Dong
authors.initials: KD
authors.lastname: Yoo
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology; D003331:Coronary Vessels / Q000378:metabolism* / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D017127:Glycation End Products, Advanced / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000097:blood*; D012107:Research Design; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D007334:Insulin-Like Growth Factor I; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic