1. Comparison of Endothelial Dysfunction in Coronary Arteries with Bare Metal and 2nd-Generation Drug-Eluting Stents
- Author
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Hiroyuki Tsutsui, Shunsuke Katsuki, Kensuke Noma, Susumu Takase, Yusuke Akiyama, Yasuhiro Nakano, Tetsuya Matoba, and Soichi Nakashiro
- Subjects
Bare-metal stent ,medicine.medical_specialty ,Acute coronary syndrome ,business.industry ,medicine.medical_treatment ,Biochemistry (medical) ,Percutaneous coronary intervention ,Vasomotion ,030204 cardiovascular system & hematology ,medicine.disease ,Coronary arteries ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Internal medicine ,Conventional PCI ,Internal Medicine ,medicine ,Cardiology ,Endothelial dysfunction ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery ,Coronary sinus - Abstract
Aims Previous studies suggested that implantation with a 1st-generation DES was associated with coronary endothelial dysfunction, which was associated with Rho-kinase activation. Second-generation drug-eluting stents (DESs) may preserve coronary endothelial function in stented coronary arteries; however, because of methodological limitations, further study is needed to clarify the association between 2nd-generation DESs and coronary endothelial dysfunction. Methods We retrospectively analysed the CuVIC trial database, where we identified 112 patients who underwent coronary stenting in the left coronary arteries with either a bare metal stent (BMS, n=53) or 2nd-generation DES (n=59). We compared vasomotions of target vessels with stents and non-target vessels without stents. Furthermore, we measured the Rho-kinase activation detected in mononucleocytes from aortic and coronary sinus blood. Results ACh-induced vasoconstrictive responses of target vessels were not enhanced with a 2nd-generation DES (45±21% vs. 44±20%, P=0.56, paired t-test), but significantly enhanced in the coronary arteries with a BMS (50±18% vs. 42±20%, P=0.002). Rho-kinase activation did not differ between patients with a BMS and 2nd-generation DES. In the target vessels with a BMS, large late lumen loss and acute coronary syndrome (ACS) at the index percutaneous coronary intervention (PCI) were associated with ACh-induced enhanced coronary vasoconstrictive responses. Conclusions Evaluation of ACh-induced vasomotion of target vessels comparing with non-target vessels revealed that 2nd-generation DESs were not associated with coronary endothelial dysfunction in target vessels, nor activation of Rho-kinase in the coronary sinus blood 6-8 months after stenting.
- Published
- 2022