Abstract 1147: Drug Eluting Stents Do Not Delay Early Endothelialization But Show Distinct Differences In Endothelial Function

Circulation(2008)

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摘要
Late stent thrombosis and impaired endothelium dependent vasodilation in Cypher and Taxus are often attributed to delayed re-endothelialization. Data to support this hypothesis is scarce and the functional status of endothelium within these drug eluting stents is unknown. We compared 3 DES (Paclitaxel; Sirolimus (-limus via mTOR) and Tacrolimus (-limus via calcineurin)) to BMS in swine coronary arteries with respect to early endothelialization (%EC) at 5 days and function as assessed by immunocytochemistry for eNOS and vWF expression at 28 days (semiquantitative score) and in vitro vasoreactivity at 5 and 28 days. Results. There were no significant differences in %EC between DES and BMS at 5 days (Anova, p=0.7). While vWF expression was similar for all DES, PES showed diminished eNOS expression at 28 days. Microvascular function showed no overt impairment distal to both DES in EC-dependent dilation to bradykinin at 5 and 28 days. However, eNOS blockade by L-NAME uncovered a strongly depressed NO production in both DES at 5 days which recovered at 28 days. Conclusion. DES show no differences in re-endothelialization as compared to BMS. In vitro data showed that both DES induced a temporary reduction in NO production. However, only Paclitaxel showed a prolonged reduction in eNOS expression at 28 days. planimetry of endothelial presence and function
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