Impact of stenting and oral sirolimus on endothelium-dependent and independent coronary vasomotion.

Abstract:

BACKGROUND:There is no consensus regarding the impact of stenting on long-term endothelial function. There have been reports of increased endothelial dysfunction with sirolimus-eluting stents as compared to bare metal stenting (BMS). OBJECTIVE:This study aims to assess the impact of BMS and the effect of oral sirolimus on endothelial function. METHODS:Forty-five patients were randomized into three groups: BMS + high-dose oral sirolimus (initial dose of 15 mg, followed by 6 mg/day for four weeks); BMS + low-dose sirolimus (6 mg followed by 2 mg daily for four weeks); and BMS without sirolimus. Changes in vasoconstriction or vasodilation in a 15 mm segment starting at the distal stent end in response to acetylcholine and nitroglycerin were assessed by quantitative angiography. RESULTS:The groups had similar angiographic characteristics. The percent variation in diameter in response to acetylcholine was similar in all groups at the two time points (p = 0.469). Four hours after stenting, the target segment presented an endothelial dysfunction that was maintained after eight months in all groups. In all groups, endothelium-independent vasomotion in response to nitroglycerin was similar at four hours and eight months, with increased target segment diameter after nitroglycerin infusion (p = 0.001). CONCLUSION:The endothelial dysfunction was similarly present at the 15 mm segment distal to the treated segment, at 4 hours and 8 months after stenting. Sirolimus administered orally during 4 weeks to prevent restenosis did not affect the status of endothelium-dependent and independent vasomotion.

journal_name

Arq Bras Cardiol

authors

Fernandes RW,Dantas JM,Oliveira DC,Bezerra HG,Brito FS Jr,Lima VC

doi

10.1590/s0066-782x2012005000022

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

290-8

issue

4

eissn

0066-782X

issn

1678-4170

pii

S0066-782X2012005000022

journal_volume

98

pub_type

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