Optical Coherence Tomography Assessment of Glucose Fluctuation Impact on the Neointimal Proliferation After Stent Implantation in a Diabetic/Hypercholesterolemic Swine Model

Int Heart J. 2017 Aug 3;58(4):608-614. doi: 10.1536/ihj.16-574. Epub 2017 Jul 10.

Abstract

The aim of the present study was to investigate the effects of glucose fluctuation on neointimal proliferation after stent implantation by optical coherence tomography (OCT) in a diabetic/hypercholesterolemic (DM/HC) swine model.A total of 24 everolimus-eluting stents (EES) were implanted in the right coronary artery (RCA) of the animals using a 20% overstretch ratio. The 24 swines were divided into a DM-high glucose fluctuation (HGF) group (n = 8), DMlow glucose fluctuation (LGF) group (n = 8), and a control group (n = 8). Percent diameter stenosis (%DS), late loss (LL), percent area stenosis (%AS), and neointimal thickness (NIT) were analyzed. The differences in neointimal characteristics and circulating oxidative stress and inflammation biomarkers were assessed and measured.At 28 days, the highest values of %DS, LL, %AS, and NIT were achieved in the HGF group followed by the LGF group (P < 0.05) and the control group (P < 0.05). The highest frequency of the heterogeneous pattern was in the HGF group followed by the LGF group (P < 0.05) and the control group (P < 0.05). This was also the case for the oxidative stress and inflammation biomarkers.DM might have a deleterious impact on neointimal proliferation after EES implantation in this DM/HC swine model. The extent of glucose fluctuation may be related to the degree of neointimal proliferation and this needs to be further confirmed by long-term follow-up and histology.

Keywords: Diabetes mellitus; Glucose variability; Intima; Intravascular imaging.

MeSH terms

  • Animals
  • Blood Glucose / metabolism*
  • Cell Proliferation / drug effects
  • Coronary Stenosis / blood
  • Coronary Stenosis / diagnosis
  • Coronary Stenosis / surgery
  • Diabetes Mellitus, Experimental / blood
  • Diabetes Mellitus, Experimental / complications*
  • Drug-Eluting Stents*
  • Everolimus / pharmacology
  • Graft Occlusion, Vascular / blood
  • Graft Occlusion, Vascular / diagnosis*
  • Graft Occlusion, Vascular / etiology
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / diagnosis*
  • Hypercholesterolemia / surgery
  • Immunosuppressive Agents / pharmacology
  • Male
  • Neointima / pathology*
  • Prognosis
  • Swine
  • Swine, Miniature
  • Tomography, Optical Coherence / methods*

Substances

  • Blood Glucose
  • Immunosuppressive Agents
  • Everolimus