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Cardiovascular Diabetology
Published in: Cardiovascular Diabetology 1/2023

Open Access 01-12-2023 | Exenatide | Research

Effects of exenatide on coronary stent’s endothelialization in subjects with type 2 diabetes: a randomized controlled trial. The Rebuild study

Authors: Irene Santos-Pardo, Nils Witt, Oskar Angerås, Thomas Nyström

Published in: Cardiovascular Diabetology | Issue 1/2023

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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).
Appendix
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Metadata
Title
Effects of exenatide on coronary stent’s endothelialization in subjects with type 2 diabetes: a randomized controlled trial. The Rebuild study
Authors
Irene Santos-Pardo
Nils Witt
Oskar Angerås
Thomas Nyström
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2023
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-023-02071-4

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