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Morphological, Functional, and Biological Vascular Healing Response 6 Months After Drug‐Eluting Stent Implantation
Author(s) -
Nakata Tsuyoshi,
Fujii Kenichi,
Fukunaga Masashi,
Shibuya Masahiko,
Kawai Kenji,
Kawasaki Daizo,
Naito Yoshiro,
Ohyanagi Mitsumasa,
Masuyama Tohru
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26273
Subject(s) - medicine , stent , cardiology , everolimus , drug eluting stent , sirolimus , urology , restenosis
Objectives This study evaluated coronary endothelial function after the implantation of sirolimus‐eluting stents (SESs), everolimus‐eluting stents (EESs), and zotarolimus‐eluting stents (ZES) by a different methodology, and also analyzed whether optical coherence tomography (OCT) findings represent endothelial healing after stenting. Background It is unclear whether OCT assessment of stent strut coverage represents endothelial healing after drug‐eluting stent implantation. Methods Thirty patients with a left anterior descending artery lesion were randomized 1:1:1 to receive an SES, EES, or ZES. The vascular response was evaluated 6 months after stenting by three methods: the functional response by acetylcholine infusion, the morphological response by OCT, and the biological response by measuring vascular endothelial growth factor (VEGF) levels. Results The proportion of uncovered struts by OCT at 6 months was significantly higher in both SES and EES than in ZES. However, the vasomotor response was impaired and the VEGF level of the coronary sinus was significantly lower in SES than in EES and ZES. There were no relationships between the OCT findings and vasomotor response to acetylcholine and VEGF levels in all cohorts. Conclusions The vascular response at 6 months was more preserved in ZES and EES than in SES. Our results suggest that the morphological assessment with OCT may not always be used as a surrogate for functional and biological healing response after stenting. © 2015 Wiley Periodicals, Inc.