title: Metformin impairs endothelialization after placement of newer generation drug eluting stents.
abstract: OBJECTIVE
  Metformin impairs endothelialization of drug eluting stents (DES) due to convergent signaling at the mammalian target of rapamycin (mTOR) pathway. We assessed whether metformin will continue to adversely affect stent endothelialization despite design improvements in newer generation DES.
  
  
  METHODS
  Rabbit iliac artery stenting with newer generation DES was performed followed by 14 days of either normal chow diet or one with metformin (100 mg/kg/day) added. Scanning electron microscopy was used to assess stent endothelialization after sacrifice.
  
  
  RESULTS
  In the metformin-treated group there was significantly less endothelialization compared to the placebo-treated group. Paclitaxel-eluting stents in placebo-treated group had the greatest degree of endothelialization with significantly less in its metformin-treated counterpart and all-limus eluting stent groups.
  
  
  CONCLUSIONS
  Metformin inhibited stent endothelialization in newer generation DES despite improvements in stent design. By impairing stent endothelialization, metformin may increase the risk for thrombotic complications after newer generation DES placement.
authors.affiliation: Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Anwer
authors.initials: A
authors.lastname: Habib
authors.forename: Vinit
authors.initials: V
authors.lastname: Karmali
authors.forename: Rohini
authors.initials: R
authors.lastname: Polavarapu
authors.forename: Hirokuni
authors.initials: H
authors.lastname: Akahori
authors.forename: Kim
authors.initials: K
authors.lastname: Pachura
authors.forename: Aloke V
authors.initials: AV
authors.lastname: Finn
mesh_terms: D000800:Angioplasty, Balloon / Q000009:adverse effects; D000818:Animals; D004195:Disease Models, Animal; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000473:pathology; D000068338:Everolimus; D007004:Hypoglycemic Agents / Q000494:pharmacology; D007083:Iliac Artery / Q000187:drug effects* / Q000293:injuries* / Q000473:pathology; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008687:Metformin / Q000494:pharmacology*; D017239:Paclitaxel / Q000494:pharmacology*; D011817:Rabbits; D020123:Sirolimus / Q000031:analogs & derivatives / Q000494:pharmacology; D013927:Thrombosis / Q000473:pathology; D050257:Tubulin Modulators / Q000494:pharmacology
chemical_list: D007004:Hypoglycemic Agents; D007166:Immunosuppressive Agents; D050257:Tubulin Modulators; D008687:Metformin; D000068338:Everolimus; C489443:zotarolimus; D017239:Paclitaxel; D020123:Sirolimus
keywords: Drug eluting stents; Metformin; Vascular endothelium