title: Usefulness of preprocedural levels of advanced glycation end products to predict restenosis in patients with controlled diabetes mellitus undergoing drug-eluting stent implantation for stable angina pectoris (from the Prospective ARMYDA-AGEs Study).
abstract: Diabetes mellitus (DM) remains the main predictor of restenosis rates and cardiovascular events following successful percutaneous coronary intervention (PCI) despite the use of drug-eluting stents (DES). HbA1c <6.0% is considered an index of optimized metabolic control in patients with DM, but several studies are downsizing its role in the clinical management of these patients. Increasing evidence points at the role of advanced glycation end products (AGEs) in restenosis pathogenesis independently on Hb1AC levels. Thus, we investigated the predictive value of preprocedural AGE levels for in-stent restenosis in a population of euglycaemic diabetic patients undergoing PCI with DES implantation. One hundred twenty-five consecutive patients with DM in optimized glycemic control admitted for stable angina pectoris and treated with elective DES implantation at a tertiary hospital were prospectively included. The primary end point of the ARMYDA-AGEs study was to compare rates of angiographic ISR at 6 months after the intervention according to pre-PCI levels of AGEs. Secondary end points were the correlations of AGE levels with occurrence of periprocedural myocardial damage, major adverse cardiac events, and in-stent late loss at 6-month control coronary angiography. AGE levels >17 μM was found to be an independent predictor of ISR at 6 months and stent lumen loss. AGEs failed to predict occurrence of secondary endpoints. In conclusion, elevated AGE levels predict occurrence of in-stent restenosis after DES implantation in patients with DM on optimized glycemic control and might represent a dosable marker of adverse outcome after PCI.
authors.affiliation: Department of Cardiovascular Sciences, University Campus Bio Medico of Rome, Italy. cristianospadaccio@gmail.com
authors.forename: Cristiano
authors.initials: C
authors.lastname: Spadaccio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Patti
authors.forename: Federico
authors.initials: F
authors.lastname: De Marco
authors.forename: Raffaella
authors.initials: R
authors.lastname: Coccia
authors.forename: Fabio
authors.initials: F
authors.lastname: Di Domenico
authors.forename: Francesco
authors.initials: F
authors.lastname: Pollari
authors.forename: Roberta
authors.initials: R
authors.lastname: Zanzonico
authors.forename: Matteo
authors.initials: M
authors.lastname: Pettinari
authors.forename: Mario
authors.initials: M
authors.lastname: Lusini
authors.forename: Germano
authors.initials: G
authors.lastname: Di Sciascio
authors.forename: Elvio
authors.initials: E
authors.lastname: Covino
authors.forename: Massimo
authors.initials: M
authors.lastname: Chello
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000097:blood* / Q000628:therapy*; D000069059:Atorvastatin; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000097:blood*; D048909:Diabetes Complications / Q000097:blood*; D054855:Drug-Eluting Stents; D005260:Female; D017127:Glycation End Products, Advanced / Q000097:blood*; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D017239:Paclitaxel / Q000627:therapeutic use; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011758:Pyrroles / Q000627:therapeutic use; D012372:ROC Curve; D050257:Tubulin Modulators / Q000627:therapeutic use
chemical_list: D017127:Glycation End Products, Advanced; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D050257:Tubulin Modulators; D000069059:Atorvastatin; D017239:Paclitaxel