Interference of drug-eluting stents with endothelium-dependent coronary vasomotion: evidence for device-specific responses.
Détails
ID Serval
serval:BIB_195BE753CD6B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Interference of drug-eluting stents with endothelium-dependent coronary vasomotion: evidence for device-specific responses.
Périodique
Circulation. Cardiovascular Interventions
ISSN
1941-7632 (Electronic)
ISSN-L
1941-7640
Statut éditorial
Publié
Date de publication
2008
Peer-reviewed
Oui
Volume
1
Numéro
3
Pages
193-200
Langue
anglais
Résumé
BACKGROUND: There is evidence that endothelial coverage of drug-eluting stents might be delayed or absent, a risk factor for late thrombotic events. We studied the effects of different drug-polymer-device iterations on endothelium-dependent coronary vasomotion. Systemic markers of endothelial inflammation were correlated with coronary vasomotor changes.
METHODS AND RESULTS: Patients with paclitaxel-eluting stents (n=11), sirolimus-eluting stents (n=21), biolimus A9-eluting stents (n=28), zotarolimus-eluting stents (n=10), and bare-metal stents (n=13) were studied 10, 9, 9, 9, and 12 months after implantation, respectively. Endothelium-dependent coronary vasomotion was tested proximally and distally to the stent and at a reference vessel segment during atrial pacing at increasing heart rates by quantitative coronary angiography. Indexes of platelet-monocyte binding and other biomarkers were studied in a subgroup of 19 patients. The baseline characteristics and hemodynamics of the patients in the different stent groups were comparable. Significant differences were observed across the 5 stent groups, concerning the vasomotion of segments proximal (P=0.006) and distal (P=0.003) to the stent. Normal vasomotion (vasodilatation) was maintained in the biolimus A9-eluting stent, zotarolimus-eluting stent, and bare-metal stent groups, whereas vasoconstriction was observed in the sirolimus-eluting stent and paclitaxel-eluting stent groups. Platelet-monocyte binding in whole blood showed a significant inverse correlation with vasomotion in reference but not in segments adjacent to the stent (r=-0.57; P=0.01).
CONCLUSIONS: Paclitaxel-eluting stents and sirolimus-eluting stents seem to cause endothelial dysfunction of the implanted vessel, whereas biolimus A9-eluting stents and zotarolimus-eluting stents behave more closely to bare-metal stents, with preserved endothelial vasomotor response. Coronary vasoconstriction was not associated with detectable systemic endothelial activation.
METHODS AND RESULTS: Patients with paclitaxel-eluting stents (n=11), sirolimus-eluting stents (n=21), biolimus A9-eluting stents (n=28), zotarolimus-eluting stents (n=10), and bare-metal stents (n=13) were studied 10, 9, 9, 9, and 12 months after implantation, respectively. Endothelium-dependent coronary vasomotion was tested proximally and distally to the stent and at a reference vessel segment during atrial pacing at increasing heart rates by quantitative coronary angiography. Indexes of platelet-monocyte binding and other biomarkers were studied in a subgroup of 19 patients. The baseline characteristics and hemodynamics of the patients in the different stent groups were comparable. Significant differences were observed across the 5 stent groups, concerning the vasomotion of segments proximal (P=0.006) and distal (P=0.003) to the stent. Normal vasomotion (vasodilatation) was maintained in the biolimus A9-eluting stent, zotarolimus-eluting stent, and bare-metal stent groups, whereas vasoconstriction was observed in the sirolimus-eluting stent and paclitaxel-eluting stent groups. Platelet-monocyte binding in whole blood showed a significant inverse correlation with vasomotion in reference but not in segments adjacent to the stent (r=-0.57; P=0.01).
CONCLUSIONS: Paclitaxel-eluting stents and sirolimus-eluting stents seem to cause endothelial dysfunction of the implanted vessel, whereas biolimus A9-eluting stents and zotarolimus-eluting stents behave more closely to bare-metal stents, with preserved endothelial vasomotor response. Coronary vasoconstriction was not associated with detectable systemic endothelial activation.
Mots-clé
Blood Platelets/physiology, Cardiovascular Agents/pharmacology, Cell Aggregation/physiology, Coronary Angiography, Coronary Vessels/drug effects, Coronary Vessels/physiology, Drug-Eluting Stents, Endothelium, Vascular/drug effects, Endothelium, Vascular/physiology, Female, Humans, Male, Middle Aged, Monocytes/physiology, P-Selectin/metabolism, Paclitaxel/pharmacology, Sirolimus/analogs & derivatives, Sirolimus/pharmacology, Vasoconstriction/drug effects, Vasoconstriction/physiology, Vasodilation/drug effects, Vasodilation/physiology
Pubmed
Web of science
Création de la notice
16/02/2015 19:01
Dernière modification de la notice
20/08/2019 13:50