Hamilos Michalis, Ribichini Flavio, Ostojic Miodrag C, Ferrero Valeria, Orlic Dejan, Vassanelli Corrado, Karanovic Nevena, Sarno Giovanna, Cuisset Thomas, Vardas Panos E, Wijns William
Cardiology Department, University Hospital of Heraklion, Heraklion, Greece.
J Cardiovasc Transl Res. 2014 Jun;7(4):406-12. doi: 10.1007/s12265-014-9568-2. Epub 2014 May 3.
First-generation drug-eluting stents (DES) have been associated with impaired localized coronary vasomotion and delayed endothelialization. We aimed to compare coronary vasomotion after implantation of a newer-generation everolimus-eluting stent (EES), with a first-generation paclitaxel-eluting stent (PES). Coronary vasomotion was studied in 19 patients with EES and 13 with PES. Vasomotor response was measured proximally and distally to the stent and in a remote vessel (reference segment). Quantitative coronary angiography was performed offline. Endothelium independent vasomotion did not differ significantly between the two groups. EES showed significant vasodilatation while PES showed vasoconstriction at both proximal (+4.5 ± 3.6 vs -4.2 ± 6.9, p < 0.001) and distal (+4.6 ± 7.9 vs -4.8 ± 9.3, p = 0.003) segments. The reference segment did not show any significant difference in vasodilatation between the two groups (+9.8 ± 6.4 vs +7.2 ± 5.2, p = 0.17). Endothelium-dependent vasomotion at adjacent stent segments is relatively preserved after EES implantation while vasoconstriction was observed after PES implantation.
第一代药物洗脱支架（DES）与局部冠状动脉血管运动受损和内皮化延迟有关。我们旨在比较新一代依维莫司洗脱支架（EES）与第一代紫杉醇洗脱支架（PES）植入后的冠状动脉血管运动情况。对19例植入EES的患者和13例植入PES的患者进行了冠状动脉血管运动研究。在支架近端和远端以及一个远离的血管（参照节段）测量血管舒缩反应。离线进行定量冠状动脉造影。两组之间内皮依赖性血管运动无显著差异。EES在近端（+4.5±3.6对-4.2±6.9，p<0.001）和远端（+4.6±7.9对-4.8±9.3，p=0.003）节段均显示出显著的血管扩张，而PES则显示血管收缩。两组在参照节段的血管扩张方面无任何显著差异（+9.8±6.4对+7.2±5.2，p=0.17）。EES植入后相邻支架节段的内皮依赖性血管运动相对得以保留，而PES植入后则观察到血管收缩。
