Effects of exenatide on coronary stent’s endothelialization in subjects with type 2 diabetes: a randomized controlled trial. The Rebuild study
Abstract Background Subjects with type 2 diabetes (T2D) have a higher risk of in-stent restenosis and stent thrombosis. The activation of the glucagon-like peptide-1 receptor (GLP-1R) has been suggested to induce several effects on the vasculature that may reduce the risk of stent failure following...
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-023-02071-4 |
| _version_ | 1797398242349023232 |
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| author | Irene Santos-Pardo Nils Witt Oskar Angerås Thomas Nyström |
| author_facet | Irene Santos-Pardo Nils Witt Oskar Angerås Thomas Nyström |
| author_sort | Irene Santos-Pardo |
| collection | DOAJ |
| description | Abstract Background Subjects with type 2 diabetes (T2D) have a higher risk of in-stent restenosis and stent thrombosis. The activation of the glucagon-like peptide-1 receptor (GLP-1R) has been suggested to induce several effects on the vasculature that may reduce the risk of stent failure following an angioplasty. The aim of this study is to evaluate the effect of the GLP-1R agonist exenatide on endothelialization of a modern drug-eluting stent (DES) in subjects with T2D. Methods 38 subjects with T2D who were eligible for revascularization with implantation of DES were randomized to treatment with exenatide (once weekly) plus standard treatment, or to standard treatment alone. After 12 weeks, a new coronary angiography was performed to evaluate the percentage of strut coverage (primary endpoint) and the presence of neo-atherosclerosis by optical coherence tomography. This study was approved by the Stockholm’s Ethical Review Board. Results The two groups were well balanced regarding baseline clinical characteristics. Strut coverage was 95% (88.7–98.5%) in the exenatide group and 91.4% (88.8–98.5%) in the control group (p = 0.692). There were no significant differences between groups neither in the thickness of neo-intima (0.2 mm in both groups, p = 0.471), nor the maximal in-stent obstruction by neo-intima (15.5% in exenatide group vs 14.7% in control group, p = 0.801). No significant differences were detected in the rate of target lesion revascularization between groups (p = 0.224). Conclusion Twelve weeks treatment with exenatide did not lead to a significantly better stent coverage in people with T2D. No significant differences in the occurrence of neo-atherosclerosis were detected between groups. Trial registration: The study was registered at www.clinicaltrials.gov (Rebuild Study, NCT02621489). |
| first_indexed | 2024-03-09T01:21:46Z |
| format | Article |
| id | doaj.art-c292eeff4b144f65b960406fa967db61 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-03-09T01:21:46Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-c292eeff4b144f65b960406fa967db612023-12-10T12:06:14ZengBMCCardiovascular Diabetology1475-28402023-12-0122111310.1186/s12933-023-02071-4Effects of exenatide on coronary stent’s endothelialization in subjects with type 2 diabetes: a randomized controlled trial. The Rebuild studyIrene Santos-Pardo0Nils Witt1Oskar Angerås2Thomas Nyström3Department of Clinical Science and Education, Karolinska Institute, Unit of CardiologyDepartment of Clinical Science and Education, Karolinska Institute, Unit of CardiologyDepartment of Molecular and Clinical Medicine, Institute of Medicine, University of GothenburgDepartment of Clinical Science and Education, Unit of Internal Medicine, Karolinska InstituteAbstract Background Subjects with type 2 diabetes (T2D) have a higher risk of in-stent restenosis and stent thrombosis. The activation of the glucagon-like peptide-1 receptor (GLP-1R) has been suggested to induce several effects on the vasculature that may reduce the risk of stent failure following an angioplasty. The aim of this study is to evaluate the effect of the GLP-1R agonist exenatide on endothelialization of a modern drug-eluting stent (DES) in subjects with T2D. Methods 38 subjects with T2D who were eligible for revascularization with implantation of DES were randomized to treatment with exenatide (once weekly) plus standard treatment, or to standard treatment alone. After 12 weeks, a new coronary angiography was performed to evaluate the percentage of strut coverage (primary endpoint) and the presence of neo-atherosclerosis by optical coherence tomography. This study was approved by the Stockholm’s Ethical Review Board. Results The two groups were well balanced regarding baseline clinical characteristics. Strut coverage was 95% (88.7–98.5%) in the exenatide group and 91.4% (88.8–98.5%) in the control group (p = 0.692). There were no significant differences between groups neither in the thickness of neo-intima (0.2 mm in both groups, p = 0.471), nor the maximal in-stent obstruction by neo-intima (15.5% in exenatide group vs 14.7% in control group, p = 0.801). No significant differences were detected in the rate of target lesion revascularization between groups (p = 0.224). Conclusion Twelve weeks treatment with exenatide did not lead to a significantly better stent coverage in people with T2D. No significant differences in the occurrence of neo-atherosclerosis were detected between groups. Trial registration: The study was registered at www.clinicaltrials.gov (Rebuild Study, NCT02621489).https://doi.org/10.1186/s12933-023-02071-4Type 2 diabetesGlucagon-like peptide-1 receptor agonistsExenatideStent endothelializationDrug eluting stent |
| spellingShingle | Irene Santos-Pardo Nils Witt Oskar Angerås Thomas Nyström Effects of exenatide on coronary stent’s endothelialization in subjects with type 2 diabetes: a randomized controlled trial. The Rebuild study Cardiovascular Diabetology Type 2 diabetes Glucagon-like peptide-1 receptor agonists Exenatide Stent endothelialization Drug eluting stent |
| title | Effects of exenatide on coronary stent’s endothelialization in subjects with type 2 diabetes: a randomized controlled trial. The Rebuild study |
| title_full | Effects of exenatide on coronary stent’s endothelialization in subjects with type 2 diabetes: a randomized controlled trial. The Rebuild study |
| title_fullStr | Effects of exenatide on coronary stent’s endothelialization in subjects with type 2 diabetes: a randomized controlled trial. The Rebuild study |
| title_full_unstemmed | Effects of exenatide on coronary stent’s endothelialization in subjects with type 2 diabetes: a randomized controlled trial. The Rebuild study |
| title_short | Effects of exenatide on coronary stent’s endothelialization in subjects with type 2 diabetes: a randomized controlled trial. The Rebuild study |
| title_sort | effects of exenatide on coronary stent s endothelialization in subjects with type 2 diabetes a randomized controlled trial the rebuild study |
| topic | Type 2 diabetes Glucagon-like peptide-1 receptor agonists Exenatide Stent endothelialization Drug eluting stent |
| url | https://doi.org/10.1186/s12933-023-02071-4 |
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