title: Everolimus-eluting stents improve vascular response in a diabetic animal model.
abstract: BACKGROUND
  Preclinical evaluation of the vascular response of drug-eluting stents is limited especially in the setting of diabetes mellitus preventing the evaluation of changes in drug-eluting stent design and eluted drugs after clinical use.
  
  
  RESULTS
  Cultured human aortic endothelial cells were used to assess the differences between sirolimus and its analog, everolimus, in the setting of hyperglycemia on various cellular functions necessary for endothelial recovery. A diabetic rabbit model of iliac artery stenting was used to compare histological and morphometric characteristics of the vascular response to everolimus-eluting, sirolimus-eluting, and bare metal stent placement. Under hyperglycemic conditions, sirolimus impaired human aortic endothelial cell barrier function, migration, and proliferation to a greater degree compared with everolimus. In our in vivo model of diabetes mellitus, endothelialization at 28 days was significantly lower and endothelial integrity was impaired in sirolimus-eluting stent compared with both everolimus-eluting and bare metal stents. Neointimal area, uncovered struts, and fibrin deposition were significantly higher in sirolimus-eluting compared with everolimus-eluting and bare metal stents.
  
  
  CONCLUSIONS
  Use of everolimus-eluting stent results in improved vascular response in our preclinical models of diabetes mellitus.
authors.affiliation: From the Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA (A.H., V.K., M.C.J., R.P., K.P., T.D., A.V.F.); and CVPath Institute, Inc, Gaithersburg, MD (G.N., F.D.K., R.V.).
authors.forename: Anwer
authors.initials: A
authors.lastname: Habib
authors.affiliation: From the Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA (A.H., V.K., M.C.J., R.P., K.P., T.D., A.V.F.); and CVPath Institute, Inc, Gaithersburg, MD (G.N., F.D.K., R.V.).
authors.forename: Vinit
authors.initials: V
authors.lastname: Karmali
authors.affiliation: From the Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA (A.H., V.K., M.C.J., R.P., K.P., T.D., A.V.F.); and CVPath Institute, Inc, Gaithersburg, MD (G.N., F.D.K., R.V.).
authors.forename: Michael C
authors.initials: MC
authors.lastname: John
authors.affiliation: From the Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA (A.H., V.K., M.C.J., R.P., K.P., T.D., A.V.F.); and CVPath Institute, Inc, Gaithersburg, MD (G.N., F.D.K., R.V.).
authors.forename: Rohini
authors.initials: R
authors.lastname: Polavarapu
authors.affiliation: From the Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA (A.H., V.K., M.C.J., R.P., K.P., T.D., A.V.F.); and CVPath Institute, Inc, Gaithersburg, MD (G.N., F.D.K., R.V.).
authors.forename: Gaku
authors.initials: G
authors.lastname: Nakazawa
authors.affiliation: From the Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA (A.H., V.K., M.C.J., R.P., K.P., T.D., A.V.F.); and CVPath Institute, Inc, Gaithersburg, MD (G.N., F.D.K., R.V.).
authors.forename: Kim
authors.initials: K
authors.lastname: Pachura
authors.affiliation: From the Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA (A.H., V.K., M.C.J., R.P., K.P., T.D., A.V.F.); and CVPath Institute, Inc, Gaithersburg, MD (G.N., F.D.K., R.V.).
authors.forename: Talina
authors.initials: T
authors.lastname: Davis
authors.affiliation: From the Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA (A.H., V.K., M.C.J., R.P., K.P., T.D., A.V.F.); and CVPath Institute, Inc, Gaithersburg, MD (G.N., F.D.K., R.V.).
authors.forename: Frank D
authors.initials: FD
authors.lastname: Kolodgie
authors.affiliation: From the Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA (A.H., V.K., M.C.J., R.P., K.P., T.D., A.V.F.); and CVPath Institute, Inc, Gaithersburg, MD (G.N., F.D.K., R.V.). avfinn@emory.edu.
authors.forename: Renu
authors.initials: R
authors.lastname: Virmani
authors.affiliation: From the Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA (A.H., V.K., M.C.J., R.P., K.P., T.D., A.V.F.); and CVPath Institute, Inc, Gaithersburg, MD (G.N., F.D.K., R.V.).
authors.forename: Aloke V
authors.initials: AV
authors.lastname: Finn
mesh_terms: D000818:Animals; D001011:Aorta / Q000473:pathology*; D002465:Cell Movement / Q000187:drug effects; D002478:Cells, Cultured; D003920:Diabetes Mellitus / Q000628:therapy*; D004195:Disease Models, Animal; D054855:Drug-Eluting Stents / Q000706:statistics & numerical data*; D042783:Endothelial Cells / Q000187:drug effects*; D000068338:Everolimus; D005337:Fibrin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000628:therapy*; D007083:Iliac Artery / Q000378:metabolism / Q000473:pathology; D008297:Male; D058426:Neointima; D011817:Rabbits; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives
chemical_list: D005337:Fibrin; D000068338:Everolimus; D020123:Sirolimus
keywords: diabetes mellitus; drug-eluting stents