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Diabetics Have Significantly More Coronary Restenosis

Worse acute procedure results and increased neointimal proliferation are the culprits

THURSDAY, Nov. 2 (HealthDay News) -- Diabetics have significantly higher coronary restenosis rates than non-diabetics due to inferior procedural outcomes and increased neointimal cell proliferation, according to a report in the November issue of the American Journal of Cardiology.

Peter Radke, M.D., of the University Hospital Aachen in Aachen, Germany, and colleagues compared acute lumen gain and late lumen loss after coronary stent surgery in 133 diabetics and 182 non-diabetics in a matched-pair study of 192 lesions in each group.

The lesions were sorted by reference diameter, minimal luminal diameter and lesion length. Five-month angiography follow-up showed a statistically significant binary restenosis rate of 25 percent in diabetics and 14 percent in non-diabetics. Acute lumen gain was 1.47 in diabetics and 1.56 in non-diabetics, and late lumen loss was 0.64 in diabetics and 0.55 in non-diabetics.

"In conclusion, suboptimal acute procedural results and an exaggerated neointimal proliferation contributed by about 50 percent to the lower net lumen gain in the diabetes mellitus group," the authors conclude. "Patients with diabetes mellitus had a significantly higher restenosis rate even when matched for preprocedural angiographic lesion dimensions. Mechanistically, inferior procedural results, as well as exaggerated neointimal proliferation, are, quantitatively, equally important in this process."

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