Long-term results of stenting in patients with multivessel coronary disease and concomitant diabetes mellitus type II with drug-eluting stents «zotarolimus»

DOI: https://doi.org/10.25512/DIR.2015.09.1.06

For quoting:
Kichin V.V., Sozikin A.V., Yurishchev A.Y., Badikov E.F., Loboda A.A. "Long-term results of stenting in patients with multivessel coronary disease and concomitant diabetes mellitus type II with drug-eluting stents «zotarolimus»". Journal Diagnostic & interventional radiology. 2015; 9(1); 46-52.

authors:

Kichin V.V.

Sozikin A.V.

Yurishchev A.Y.

Badikov E.F.

Loboda A.A.

keywords:

ischemic heart disease

coronary stenting

bare metal stents

drug-eluting stents «Zotarolimus»

diabetes mellitus type II

restenosis

Abstract:

Aim: was to analyze long-term results of coronary artery stenting with drug-eluting stents «Zotarolimus» and bare metal stents in patients with a concomitant diabetes mellitus type II.

Materials and methods: 37 patients with ischemic heart disease and concomitant diabetes mellitus type II were selected for analysis; they underwent implantation of stents without drug coverage («Intergrity» «Medtronic») or stents with drug-eluting «Zotarolimus» («Resolute Integrity» «Medtronic»). All patients were divided into 2 groups: first group consisted of 11 patients, who underwent implantation of bare metal stents, second group - 26 patients who underwent implantation of drug-eluting stents, «Zotarolimus». Follow-up period was 26±4 months. Criteria of stenting efficiency were: angiographic assessment of coronary arteries anatomy in control angiography after stent implantation, reccurence of angina or functional class increase, the survival rate in the nearest postoperative period, before discharge, but not more than 30 days, and in the early post-operative period up to 6 months. In the medium-distant post-operative period - 12 months, and in the late postoperative period - 24 months.

Results: all patients underwent successfully performed endovascular revascularization. The optimal angiographic result was achieved in all patients. Regression of ischemic changes on ECG data and increase myocardial contractility by echocardiography data also were marked in all patients. In long-term follow-up period, in 5 (45%) patients with bare metal stents we noted the appearence of hemodynamically significant restenosis, that needed performance of secondary angioplasty with stenting.

Conclusion: the use of antiproliferative drug-eluting stents «Zotarolimus» is possible in treatment of patients with coronary artery disease and comorbid diagnosis of diabetes mellitus type II. Bare metal stents in coronary stenting in patients with concomitant diagnosis of diabetes mellitus type II is impractical due to developing in-stent restenosis (45% of patients).

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