title: Late lumen loss and intima hyperplasia after sirolimus-eluting and zotarolimus-eluting stent implantation in diabetic patients: the diabetes and drug-eluting stent (DiabeDES III) angiography and intravascular ultrasound trial.
abstract: OBJECTIVE
  Patients with diabetes mellitus have increased risk of in-stent restenosis after coronary stent implantation due to neointimal hyperplasia (NIH). The aim of this study was to use quantitative coronary angiography (QCA) and volumetric intravascular ultrasound (IVUS) to evaluate the effects of the sirolimus-eluting Cypher® stent (SES) and the zotarolimus-eluting Endeavor® stent (ZES) on angiographic late lumen loss and intima hyperplasia in diabetic patients.
  
  
  RESULTS
  In the DiabeDES III trial, 127 patients were randomised to SES or ZES stent implantation. Angiographic 10-month follow-up data were available in 105 patients, including 48 SES and 57 ZES treated patients. Angiographic endpoints were in-stent late lumen loss and minimal lumen diameter. IVUS endpoints included NIH volume and in-stent percent volume obstruction. Baseline clinical characteristics and lesion parameters were similar in the two groups. At 10-month follow-up, angiographic in-stent late lumen loss (0.14±0.37 mm vs. 0.74±0.45 mm, p<0.001) was reduced and minimum lumen diameter was higher (2.36±0.53 mm vs. 1.96±0.65, p<0.001) in the SES group as compared to the ZES group. As compared to the ZES group, NIH volume was significantly reduced in the SES group (median [interquartile range]: 0.0 mm3 [0.0 to 1.2] vs. 16.5 mm3 [6.2 to 31.1], p<0.001). In-stent% volume obstruction was significantly reduced in SES as compared to ZES (median [interquartile range]: 0.0% [0.0-0.7] vs. 13.0% [6.7-20.8], p<0.001).
  
  
  CONCLUSIONS
  In diabetic patients, the SES reduced angiographic late lumen loss and inhibited NIH more effectively than ZES.
authors: Department of Cardiology, Odense University Hospital, Odense, Denmark. okkels@dadlnet.dk
authors: Lisette Okkels
authors: LO
authors: Jensen
authors: Michael
authors: M
authors: Maeng
authors: Per
authors: P
authors: Thayssen
authors: Anton
authors: A
authors: Villadsen
authors: Lars
authors: L
authors: Krusell
authors: Hans Erik
authors: HE
authors: Botker
authors: Knud Erik
authors: KE
authors: Pedersen
authors: Jens
authors: J
authors: Aaroe
authors: Evald Hoej
authors: EH
authors: Christiansen
authors: Thomas
authors: T
authors: Vesterlund
authors: Knud Noerregaard
authors: KN
authors: Hansen
authors: Jan
authors: J
authors: Ravkilde
authors: Hans Henrik
authors: HH
authors: Tilsted
authors: Jens Flensted
authors: JF
authors: Lassen
authors: Leif
authors: L
authors: Thuesen
mesh_terms: D000368:Aged; D017222:Angioplasty, Balloon, Laser-Assisted / Q000295:instrumentation / Q000379:methods; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D023903:Coronary Restenosis / Q000453:epidemiology / Q000517:prevention & control; D048909:Diabetes Complications / Q000150:complications*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D058426:Neointima / Q000000981:diagnostic imaging* / Q000473:pathology*; D012307:Risk Factors; D016037:Single-Blind Method; D020123:Sirolimus / Q000009:adverse effects* / Q000031:analogs & derivatives*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: C489443:zotarolimus; D020123:Sirolimus