Letter by Brugaletta et al Regarding Article, “Interference of Drug-Eluting Stents and Endothelium-Dependent Coronary Vasomotion: Evidence for Device-Specific Responses”

To the Editor:We read with interest the article by Hamilos et al,1 demonstrating a variable endothelium-dependent coronary vasomotor response at coronary segments adjacent to different drug-eluting stents (DES) and bare metal stents. In particular, a better coronary vasodilatation induced by pacing was observed in patients receiving zotarolimus-eluting or biolimus A9–eluting stents when compared with patients receiving paclitaxel- or sirolimus-eluting stents. As discussed by the authors, endothelial dysfunction after first-generation DES may be induced by the effect of the drug, its release kinetics, the proinflammatory effect of the polymer, or the combination of these factors. However, before drawing easy conclusions, several …