Volumetric analysis of in-stent intimal hyperplasia in diabetic patients treated with or without abciximab: Results of the diabetes abciximab steNT evaluation (DANTE) randomized trial

• Published in: Circulation (New York, N.Y.) N.Y.), 2004-02, Vol.109 (7), p.861-866
• Main Authors: CHAVES, Aurea J, SOUSA, Amanda G. M. R, MALDONADO, Galo, SEIXAS, Ana, COSTA, Marco A, PAES, Angela, MINTZ, Gary S, SOUSA, J. Eduardo, MATTOS, Luiz A, ABIZAID, Alexandre, STAICO, Rodolfo, FERES, Fausto, CENTEMERO, Marinella, TANAJURA, Luiz F, ABIZAID, Andrea, PINTO, Ibraim
• Format: Article
• Language: English
• Subjects: Aged; Antibodies, Monoclonal - pharmacology; Antibodies, Monoclonal - therapeutic use; Biological and medical sciences; Blood and lymphatic vessels; Brazil - epidemiology; Cardiology. Vascular system; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Coronary Angiography; Coronary Restenosis - diagnostic imaging; Coronary Restenosis - epidemiology; Coronary Restenosis - prevention & control; Coronary Stenosis - complications; Coronary Stenosis - drug therapy; Coronary Stenosis - pathology; Coronary Stenosis - surgery; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - pathology; Disease-Free Survival; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Elective Surgical Procedures; Female; Humans; Hyperplasia; Imaging, Three-Dimensional; Immunoglobulin Fab Fragments - pharmacology; Immunoglobulin Fab Fragments - therapeutic use; Incidence; Life Tables; Male; Medical sciences; Middle Aged; Platelet Aggregation Inhibitors - pharmacology; Platelet Aggregation Inhibitors - therapeutic use; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Prospective Studies; Single-Blind Method; Stents; Treatment Failure; Tunica Intima - diagnostic imaging; Tunica Intima - pathology; Ultrasonography, Interventional - methods
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.0000116752.12261.D4

In diabetic patients in the Evaluation of Platelet IIb/IIIa Inhibitor for Stenting (EPISTENT) trial, abciximab reduced target vessel revascularization by approximately 50% compared with placebo. Whether this is a result of a lower restenosis rate caused by inhibition of intimal hyperplasia remains to be defined. The purpose of this study was to determine whether abciximab at the time of stent implantation would reduce in-stent intimal hyperplasia measured by intravascular ultrasound at 6-month follow-up in type 2 diabetics. Ninety-six diabetic patients (96 lesions) who underwent elective stent implantation for a de novo lesion in a native coronary artery were randomly assigned to receive abciximab or no abciximab. In-stent intimal hyperplasia volume, expressed as percentage of stent volume, did not differ between groups: 41.3+/-21.0% for those treated with abciximab versus 40.5+/-18.3% for those treated without abciximab (P=0.9). There were also no significant differences in angiographic minimal luminal diameter at follow-up (1.74+/-0.69 versus 1.66+/-0.63 mm; P=0.5), late loss (1.03+/-0.63 versus 1.07+/-0.58 mm; P=0.7), restenosis rate (17.8% versus 22.9%; P=0.5), or cumulative incidence of major adverse cardiac events at 12 months (19.1% versus 20.4%; P=0.9). Six-month intravascular ultrasound volumetric analysis showed that abciximab, at the time of coronary stent implantation, was not associated with a reduction of in-stent intimal hyperplasia in diabetic patients.