Specific coronary drug-eluting stents interfere with distal microvascular function after single stent implantation in pigs

JACC. Cardiovascular Interventions
Mieke van den HeuvelWillem van der Giessen

Abstract

The aim of this study was to compare the effects of single drug-eluting stents (DES) on porcine coronary function distal to the stent in vivo and in vitro. The mechanism of endothelial dysfunction occurring in human coronary conduit arteries up to 9 months after DES implantation is unknown. A sirolimus-eluting stent (SES), paclitaxel-eluting stent (PES), and a bare-metal stent (BMS) were implanted in the 3 coronary arteries of 11 pigs. After 5 weeks, in vivo responses in distal coronary flow to different doses of bradykinin (BK) and nitrates were measured. In vitro, vasodilation to BK and nitrates, as well as vasoconstriction to endothelin (ET)-1 were assessed in both distal coronary conduit and small arteries. In addition, contributions of nitric oxide (NO) and endothelium-derived hyperpolarizing factors (EDHFs) and cyclic guanosine monophosphate (cGMP) responses to BK-stimulation were determined in vitro. Both DES did not alter in vivo distal vasomotion. In vitro distal conduit and small arterial responses to BK were also unaltered; DES did not alter the BK-induced increase in cGMP. However, after NO synthase blockade, PES showed a reduced BK-response in distal small arteries as compared with BMS and SES (p < 0.05). The ET-1-...Continue Reading

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Citations

May 8, 2009·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·G ErtaşW J van der Giessen
Aug 2, 2012·Circulation. Cardiovascular Interventions·Seong-Hoon LimAmir Lerman
Sep 10, 2011·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·N S van DitzhuijzenW J van der Giessen
Apr 21, 2012·JACC. Cardiovascular Interventions·Lakshmana K PendyalaJinsheng Li
May 23, 2012·Nature Reviews. Cardiology·Fumiyuki OtsukaRenu Virmani
Oct 31, 2016·JACC. Basic to Translational Science·Nienke S van DitzhuijzenEvelyn Regar

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