Comparison of everolimus-versus paclitaxel-eluting stents implanted in patients with diabetes mellitus as evaluated by three-dimensional intravascular ultrasound analysis

Hiromasa Otake, Junya Ako, Masao Yamasaki, Ichizo Tsujino, Takao Shimohama, Takao Hasegawa, Ryota Sakurai, Katsuhisa Waseda, Yasuhiro Honda, Poornima Sood, Krishnankutty Sudhir, Gregg W. Stone, Peter J. Fitzgerald

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11 Scopus citations

Abstract

Previous reports have shown the advantage of paclitaxel compared to limus-derivative drugs for the treatment of diabetics. A total of 109 diabetics (115 lesions) treated with everolimus-eluting stents (EESs, n = 58) or paclitaxel-eluting stents (PESs, n = 55) undergoing 8 to 9 months of follow-up 3-dimensional intravascular ultrasound examinations were enrolled. In addition to the standard intravascular ultrasound parameters, the percentage of neointimal volume (neointimal volume/stent volume) and maximum percentage of cross-sectional narrowing (neointimal area/stent area) was calculated. EESs showed a lower percentage of neointimal volume (7.2 ± 7.1% vs 11.7 ± 11.0%; p = 0.01) and maximum percentage of cross-sectional narrowing (22.5 ± 16.3% vs 29.4 ± 19.2%; p = 0.04) than PESs. One case of severe narrowing (lesions with maximum percentage of cross-sectional narrowing >60%) in the EES group developed and 6 cases in the PESs group (p = 0.05). The EESs showed no serial changes for vessel or peri-stent plaque during the follow-up period, and PESs showed significant increases in vessel and peri-stent plaque. PESs showed significantly greater peri-stent plaque increase, with a tendency toward greater vessel enlargement than EESs. Late acquired incomplete stent apposition was observed in 2 PES cases. The major adverse cardiac event rate was comparable ≤2 years. In conclusion, EESs showed greater neointimal suppression without significant vessel expansion than PESs in diabetic patients. In this small cohort, no significant differences were observed in the major adverse cardiac event rate ≤2 years.

Original languageEnglish
Pages (from-to)492-497
Number of pages6
JournalAmerican Journal of Cardiology
Volume106
Issue number4
DOIs
StatePublished - 15 Aug 2010
Externally publishedYes

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