Yonsei Med J.  2005 Feb;46(1):78-85. 10.3349/ymj.2005.46.1.78.

Serum Levels of Advanced Glycation End Products Are Associated with In-Stent Restenosis in Diabetic Patients

• Choi EY
• Kwon HM
• Woo C
• Taek G
• Joung B
• Hong BK
• Yoon YW
• Kim D
• Byun KH
• Kang TS
• Yoon SJ
• Kwon SW
• Lee SJ
• Park JK
• Kim HS

• KMID: 2158116
• DOI: http://doi.org/10.3349/ymj.2005.46.1.78

Abstract

The formation of advanced glycation end products (AGEs), in various tissues has been known to enhance immunoinflammatory reactions and local oxidant stresses in long standing diabetes. Recently, AGEs have been reported to play a role in neointimal formation in animal models of arterial injury. We attempted to determine whether the serum levels of AGEs are associated with coronary restenosis in diabetic patients. Blood samples were collected from diabetic patients with coronary artery disease undergoing stent implantation and the serum levels of AGEs were analyzed by the fluorescent intensity method. The development of in-stent restenosis (ISR) was evaluated by a 6-month follow-up coronary angiography. A total of 263 target lesions were evaluated, in 203 patients. The ISR rate in the high-AGE (> 170 U/ml) group (40.1%) was significantly higher than in the low-AGE group (< or =170 U/ml) (19.6%) (p < 0.001). Furthermore, multivariate analysis revealed that a high level of serum AGEs is an independent risk factor for the development of ISR (odds ratio, 2.659; 95% CI, 1.431-4.940; p=0.002). The serum levels of AGEs constitute an excellent predictive factor for ISR, and should be one of the guidelines for medical therapy and interventional strategy to prevent ISR in diabetic patients.

Keyword

Diabetes mellitus; coronary artery disease; angioplasty; restenosis

MeSH Terms

Aged
Coronary Arteriosclerosis/epidemiology/*metabolism/*therapy
Coronary Restenosis/epidemiology/*metabolism
Diabetes Mellitus, Type 2/epidemiology/*metabolism
Female
Glycosylation End Products, Advanced/*blood
Humans
Male
Middle Aged
Research Support, Non-U.S. Gov't
Risk Factors
*Stents

Figure

• 

  Fig. 1 (A) Receiver operating characteristics (ROC) curve of the serum levels of AGEs for the in-stent restenosis (ISR). ROC area was 0.659; 95% CI 0.589 to 0.729; p<0.001. The cutoff point for levels of AGEs was 170.2 U/ml (sensitivity=0.619, specificity=0.659). (B) ISR rate in the high-AGEs (> 170 U/ml) group was 40.1%, whereas values in the low-AGEs (≤ 170 U/ml) group were 19.6%. Difference of ISR rate between two groups was statistically significant (p < 0.001).

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