Comparison of Endothelial Dysfunction in Coronary Arteries with Bare Metal and 2<sup>nd</sup>-Generation Drug-Eluting Stents

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  • Akiyama Yusuke
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Matoba Tetsuya
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Katsuki Shunsuke
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Takase Susumu
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Nakashiro Soichi
    Division of Cardiology, Matsuyama Red Cross Hospital
  • Nakano Yasuhiro
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
  • Noma Kensuke
    Medical Corporation Noma Clinic
  • Tsutsui Hiroyuki
    Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University

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<p>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 2 nd-generation DESs and coronary endothelial dysfunction. </p><p>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. </p><p>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. </p><p>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. </p>

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