Cardiac stent patients with diabetes may benefit from drug that counteracts the effects of leptin

December 18, 2008

The naturally high levels of leptin in diabetic patients may reduce the effectiveness of drug-eluting stents used to treat heart blockages, but using a chemical that differs from the one commonly used to coat stents could counteract this effect.

The work by researchers at Columbia University Medical Center could potentially improve outcomes in diabetics who get stents, they say. Though drug-eluting stents reduce the chance coronary arteries will become blocked again, clogged stents are still more common in diabetic patients than in the general population. About 250,000 Americans with diabetes receive drug-eluting stents every year.

A hormone commonly associated with obesity - leptin - may be partly responsible, according to recently published research in the Proceedings of the National Academy of Sciences by Andrew Marks, M.D., chair of physiology & cellular biophysics and Clyde and Helen Wu Professor of Molecular Cardiology, and Steven Marx, M.D., associate professor of medicine and pharmacology. The study found that leptin, at the elevated concentrations frequently found in patients with diabetes, stimulates the growth of cells responsible for clogging the stents in mice, even in the presence of sirolimus, a drug used in many stents to prevent cell growth.

The same mouse study also identified a drug - a PI3kinase inhibitor - that counteracts the effect of leptin on cell growth. If added to current drug-eluting stents, such a drug may further reduce reclogging rates in patients with diabetes to the single digit rates seen in other patients. An improved stent could significantly reduce the numbers of patients who eventually need coronary bypass surgery after their stents become severely obstructed.

Columbia University Medical Center

Colombo's Tips & Tricks for Drug Eluting Stents
by Antonio Colombo (Author), Goran Stankovic (Author)

A trailblazer in interventional cardiology, Dr. Antonio Colombo combines his vast experience with that of Goran Stankovic and distinguished colleagues to share tips and tricks for dealing with diseased coronary arteries. Whether discussing his 'crushing and kissing' techniques or the stenting of tortuous vessels in the elderly, Dr. Colombo and his colleagues' texts and case commentaries provide the reader with succinct and simple advice based on personal experience. They provide the most comprehensive and practical guide available for those involved in coronary artery stenting. The images are all down-loadable in Powerpoint and will be of tremendous use to instructors and students alike.

Handbook of Drug-Eluting Stents
by Patrick W. Serruys (Author), Anthony H. Gershlick (Author)

Handbook of Drug-Eluting Stents, under the editorial direction of Patrick Serruys, one of the world's leading interventional cardiologists, and Tony Gershlick, a pioneer in the field of drug-eluting stents, provides the reader with up-to-date information on which stents and pharmacological agents in use or about to be launched, the kinetics of the drugs involved, and what the future may hold.

The 2009-2014 World Outlook for Drug-Eluting Stents
by Icon Group International (Author)

This econometric study covers the world outlook for drug-eluting stents across more than 200 countries. For each year reported, estimates are given for the latent demand, or potential industry earnings (P.I.E.), for the country in question (in millions of U.S. dollars), the percent share the country is of the region and of the globe. These comparative benchmarks allow the reader to quickly gauge a country vis-a-vis others. Using econometric models which project fundamental economic dynamics within each country and across countries, latent demand estimates are created. This report does not discuss the specific players in the market serving the latent demand, nor specific details at the product level. The study also does not consider short-term cyclicalities that might affect realized...

The 2009-2014 Outlook for Drug-Eluting Stents in Japan
by Icon Group International (Author)

This econometric study covers the latent demand outlook for drug-eluting stents across the prefectures and cities of Japan. Latent demand (in millions of U.S. dollars), or potential industry earnings (P.I.E.) estimates are given across some 1,000 cities in Japan. For each city in question, the percent share the city is of it's prefecture and of Japan is reported. These comparative benchmarks allow the reader to quickly gauge a city vis-a-vis others. This statistical approach can prove very useful to distribution and/or sales force strategies. Using econometric models which project fundamental economic dynamics within each prefecture and city, latent demand estimates are created for drug-eluting stents. This report does not discuss the specific players in the market serving the latent...

The 2009-2014 Outlook for Drug-Eluting Stents in India
by Icon Group International (Author)

This econometric study covers the latent demand outlook for drug-eluting stents across the states, union territories and cities of India. Latent demand (in millions of U.S. dollars), or potential industry earnings (P.I.E.) estimates are given across over 5,000 cities in India. For each city in question, the percent share the city is of it's state or union territory and of India as a whole is reported. These comparative benchmarks allow the reader to quickly gauge a city vis-a-vis others. This statistical approach can prove very useful to distribution and/or sales force strategies. Using econometric models which project fundamental economic dynamics within each state or union territory and city, latent demand estimates are created for drug-eluting stents. This report does not discuss the...

The 2009-2014 Outlook for Drug-Eluting Stents in Greater China
by Icon Group International (Author)

This econometric study covers the latent demand outlook for drug-eluting stents across the regions of Greater China, including provinces, autonomous regions (Guangxi, Nei Mongol, Ningxia, Xinjiang, Xizang - Tibet), municipalities (Beijing, Chongqing, Shanghai, and Tianjin), special administrative regions (Hong Kong and Macau), and Taiwan (all hereafter referred to as "regions"). Latent demand (in millions of U.S. dollars), or potential industry earnings (P.I.E.) estimates are given across some 1,100 cities in Greater China. For each major city in question, the percent share the city is of the region and of Greater China is reported. Each major city is defined as an area of "economic population", as opposed to the demographic population within a legal geographic boundary. For many cities,...

The 2009-2014 Outlook for Drug-Eluting Stents in the United States
by Icon Group International (Author)

This econometric study covers the latent demand outlook for drug-eluting stents across the states and cities of the United States. Latent demand (in millions of U.S. dollars), or potential industry earnings (P.I.E.) estimates are given across some 12,900 cities in the United States. For each city in question, the percent share the city is of it's state and of the United States is reported. These comparative benchmarks allow the reader to quickly gauge a city vis-a-vis others. This statistical approach can prove very useful to distribution and/or sales force strategies. Using econometric models which project fundamental economic dynamics within each state and city, latent demand estimates are created for drug-eluting stents. This report does not discuss the specific players in the market...

The 2009-2014 Outlook for Drug-Eluting Stents in The Americas & the Caribbean
by Icon Group International (Author)

This econometric study covers the outlook for drug-eluting stents in The Americas & the Caribbean. For each year reported, estimates are given for the latent demand, or potential industry earnings (P.I.E.), for the country in question (in millions of U.S. dollars), the percent share the country is of the region and of the globe. These comparative benchmarks allow the reader to quickly gauge a country vis-a-vis others. Using econometric models which project fundamental economic dynamics within each country and across countries, latent demand estimates are created. This report does not discuss the specific players in the market serving the latent demand, nor specific details at the product level. The study also does not consider short-term cyclicalities that might affect realized sales. The...

The 2009-2014 Outlook for Drug-Eluting Stents in Asia
by Icon Group International (Author)

This econometric study covers the outlook for drug-eluting stents in Asia. For each year reported, estimates are given for the latent demand, or potential industry earnings (P.I.E.), for the country in question (in millions of U.S. dollars), the percent share the country is of the region and of the globe. These comparative benchmarks allow the reader to quickly gauge a country vis-a-vis others. Using econometric models which project fundamental economic dynamics within each country and across countries, latent demand estimates are created. This report does not discuss the specific players in the market serving the latent demand, nor specific details at the product level. The study also does not consider short-term cyclicalities that might affect realized sales. The study, therefore, is...

The 2009-2014 Outlook for Drug-Eluting Stents in Africa, Europe & the Middle East
by Icon Group International (Author)

This econometric study covers the outlook for drug-eluting stents in Africa, Europe & the Middle East. For each year reported, estimates are given for the latent demand, or potential industry earnings (P.I.E.), for the country in question (in millions of U.S. dollars), the percent share the country is of the region and of the globe. These comparative benchmarks allow the reader to quickly gauge a country vis-a-vis others. Using econometric models which project fundamental economic dynamics within each country and across countries, latent demand estimates are created. This report does not discuss the specific players in the market serving the latent demand, nor specific details at the product level. The study also does not consider short-term cyclicalities that might affect realized sales....