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A prospective, randomized, 6-month comparison of the coronary vasomotor response associated with a zotarolimus- versus a sirolimus-eluting stent: differential recovery of coronary endothelial dysfunction.

Abstract：

OBJECTIVES:We prospectively compared coronary endothelial dysfunction in patients with zotarolimus-eluting stent (ZES) versus sirolimus-eluting stent (SES) implantation at 6-month follow-up. BACKGROUND:A ZES has been associated with uniform and rapid healing of the endothelium. METHODS:Fifty patients were randomly treated with intravascular ultrasound-guided stenting with a single stent to the mid-segment of the left anterior descending artery (20 ZES, 20 SES, and 10 bare-metal stents), and endothelial function was estimated before and after intervention at 6-month follow-up by incremental acetylcholine (Ach) (10, 20, 50, and 100 microg/min) and nitrate (200 microg/min) infusions into the left coronary ostium. The vascular response was quantitatively measured in the 5-mm segments proximal and distal to the stent. RESULTS:In the drug-eluting stent groups, more intense vasoconstriction to incremental doses of Ach was observed at 6-month follow-up compared with the responses before stenting. Endothelial function associated with the ZES was more preserved at 6-month follow-up compared with the SES. Vasoconstriction to Ach was more prominent in the distal segments than the proximal segments in both the ZES and SES groups. Endothelium-independent vasodilation to nitrate did not differ significantly among the study groups. CONCLUSIONS:Vasoconstriction in response to Ach in the peri-stent region was less pronounced in the ZES group than the SES group at 6-month follow-up, which suggests that endothelial function associated with ZES can be more preserved than the SES.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Kim JW,Seo HS,Park JH,Na JO,Choi CU,Lim HE,Kim EJ,Rha SW,Park CG,Oh DJ

doi

10.1016/j.jacc.2009.01.051

subject

Has Abstract

pub_date

2009-05-05 00:00:00

pages

1653-9

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(09)00538-5

journal_volume

pub_type

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A prospective, randomized, 6-month comparison of the coronary vasomotor response associated with a zotarolimus- versus a sirolimus-eluting stent: differential recovery of coronary endothelial dysfunction.