Nef Holger M, Möllmann Helge, Joseph Astrid, Troidl Christian, Voss Sandra, Rauch Maximilian, Kinscherf Ralf, Vogt Achim, Weber Michael, Hamm Christian W, Elsässer Albrecht
Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany.
Clin Res Cardiol. 2009 Jun;98(6):355-61. doi: 10.1007/s00392-009-0020-6. Epub 2009 May 7.
The drug eluting stents have been shown to play a substantial role in preventing in-stent restenosis. This study was initiated to determine the efficacy of 2-deoxy-D-glucose (2-DG) in an in-stent restenosis model for reducing neointimal hyperplasia after coronary stent placement.
In a porcine overstretch model, three kinds of stents were investigated (n = 12 per group): bare metal stents (BMS), rapamycin-eluted stents (RES), and BMS after intracoronary short-term application of 2-DG (DGS). After 42 days histomorphometric and histopathological analyses were performed.
Neointimal thickness (BMS: 0.38 +/- 0.08, RES: 0.24 +/- 0.11, DGS: 0.15 +/- 0.01), area stenosis (BMS: 47.39 +/- 2.76, RES: 32.2 +/- 2.08, DGS: 29.30 +/- 2.98) did not differ after 42 days between the RES and DGS but were significantly lower as compared to BMS only. Lumen area (BMS: 3.15 +/- 1.53, RES: 4.37 +/- 1.72, DGS: 4.77 +/- 2.14) was significantly higher in the DGS group in comparison to the BMS group. The calculated injury and inflammation scores were similar and re-endothelialization was confirmed in all groups.
This study could demonstrate that in porcine stent model neointimal hyperplasia and re-endothelialization after application of 2-DG are comparable to those seen in RES. Thus, 2-DG might be a promising clinical application for coronary stent coating.
药物洗脱支架已被证明在预防支架内再狭窄方面发挥着重要作用。本研究旨在确定2-脱氧-D-葡萄糖(2-DG)在支架内再狭窄模型中减少冠状动脉支架置入后新生内膜增生的疗效。
在猪过度扩张模型中,研究了三种支架(每组n = 12):裸金属支架(BMS)、雷帕霉素洗脱支架(RES)和冠状动脉内短期应用2-DG后的BMS(DGS)。42天后进行组织形态计量学和组织病理学分析。
42天后,RES和DGS组之间的新生内膜厚度(BMS:0.38±0.08,RES:0.24±0.11,DGS:0.15±0.01)、狭窄面积(BMS:47.39±2.76,RES:32.2±2.08,DGS:29.30±2.98)无差异,但仅与BMS组相比显著降低。DGS组的管腔面积(BMS:3.15±1.53,RES:4.37±1.72,DGS:4.77±2.14)明显高于BMS组。计算出的损伤和炎症评分相似,且所有组均证实有再内皮化。
本研究表明,在猪支架模型中,应用2-DG后的新生内膜增生和再内皮化与RES相似。因此,2-DG可能是一种有前景的冠状动脉支架涂层临床应用。