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Cardiac stent patients with diabetes may benefit from drug that counteracts the effects of leptin
December 18, 2008The 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
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
Drug-eluting Stents Current Events and Drug-eluting Stents News RSSHigher carotid arterial stenting rates associated with poorer clinical outcomes
Among eligible Medicare beneficiaries, increased use of carotid arterial stenting (CAS) procedures to treat carotid stenosis-the narrowing of the carotid artery-is associated with higher rates of mortality and adverse clinical outcomes, including heart attack and stroke, according to researchers from the University of Pennsylvania School of Medicine.
Drug-eluting stents better than bare-metal stents for heart attack patients
Late-breaking data from the landmark HORIZONS-AMI clinical trial, presented at the 21st annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, demonstrated that after two years, in heart attack patients, the use of a drug-eluting stent (paclitaxel) was safer and more effective than a bare-metal stent; and that the administration of the anticoagulant medication bivalirudin enhanced safety and efficacy compared to the use of heparin + GPIIb/IIIa inhibitors.
SPIRIT IV trial shows everolimus stent sets new standard for event-free survival
Late-breaking data from SPIRIT IV, a large-scale multi-center study of nearly 4,000 patients in the U.S., shows that an everolimus-eluting stent demonstrated enhanced safety and efficacy in the treatment of de novo native coronary artery lesions when compared to a paclitaxel-eluting stent, and showed that "low late loss" may be achieved with drug-eluting stents without sacrificing safety.
Drug-eluting stents safe, effective for treatment of chronic total occlusions
A multicenter study in Asia found drug-eluting stents effective with a low rate of acute complications in patients with chronic total occlusions (CTOs) undergoing PCI. Results of the study will be presented at the 21st annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation (CRF).
Researchers find drug-eluting stents safe, effective for PCI in diabetics
Results of a multicenter study in Asia, demonstrating that drug-eluting stents are effective with a low rate of complications in diabetic patients, will be presented at the 21st annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation (CRF).
Fast release of data leads to rapid changes in clinical practice for drug-eluting stents
E-mail, search engines, smart phones and other new technologies that can disseminate new medical information quickly led to an almost immediate change in clinical practice for drug-eluting stents, according to a study reported in Circulation: Cardiovascular Quality and Outcomes.
Analysis of drug-eluting stents data demonstrates safety, efficacy in on-and-off-label use
The Cardiovascular Research Foundation (CRF) announced that results of the largest meta-analysis to date comparing mortality rates for drug-eluting stents (DES) versus bare metal stents (BMS) were published online June 15 in the journal Circulation.
NEJM study finds drug-eluting stents more effective than bare-metal stents in heart attack patients
NewYork-Presbyterian Hospital and Columbia University Medical Center, together with the Cardiovascular Research Foundation (CRF), announced that its landmark study comparing the safety and efficacy of drug-eluting stents and bare-metal stents was published in the May 7 New England Journal of Medicine.
Drug-eluting stents prove more effective, equally as safe as bare-metal stents
The Cardiovascular Research Foundation (CRF) announced that its landmark study comparing the safety and efficacy of drug-eluting stents and bare-metal stents was published today in The New England Journal of Medicine.
Drug-eluting stents found safe, superior to bare metal stents
Drug-eluting stents were safe and superior to bare metal stents in preventing death and heart attacks among 262,700 "real-world" patients enrolled in a nationwide registry of cardiovascular disease, according to researchers from Duke University Medical Center.
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