Verhaegen Carole, Kautbally Shakeel, Zapareto Diego Castanares, Brusa Davide, Courtoy Guillaume, Aydin Selda, Bouzin Caroline, Oury Cecile, Bertrand Luc, Jacques Pascal J, Beauloye Christophe, Horman Sandrine, Kefer Joelle
Pole de Recherche Cardiovasculaire, Institut de Recherche Experimentale et Clinique (IREC), Universite Catholique de Louvain (UCLouvain) Brussels, Belgium.
Division of Cardiology, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain (UCLouvain) Brussels, Belgium.
Am J Cardiovasc Dis. 2020 Jun 15;10(2):72-83. eCollection 2020.
Although 1-month dual antiplatelet therapy (DAPT) in patients treated with bare metal stents (BMS) is well established, the optimal duration of DAPT after implantation of a drug-eluting stent (DES) is still a matter of debate. The safety of shortened DAPT is under investigation due to concern about the risk of stent thrombosis. Data on platelet activation and prothrombotic response in vivo following bioresorbable polymer sirolimus-eluting stent (BP-SES) implantation are scarce.
The aim of our study was to compare the early thrombogenicity of BP-SES with that of BMS in an aortic rat model.
Overall, 30 rats underwent stent implantation in the abdominal aorta: BMS (Pro-Kinetic Energy; N=15) and BP-SES (Ultimaster Tansei; N=15) were compared in terms of their early thrombogenicity. CD62P exposure at the platelet surface and fibrinogen binding at the integrin receptor were not different between BMS and BP-SES over time. The thrombus coverage of the scaffold (0 vs. 0.1%, P=0.84) was similarly low in both groups at Day 28; thrombotic deposits had totally disappeared at Day 84. The endothelial strut coverage was similarly high at 1 month (90 vs. 95%, P=0.64) and 3 months (87 vs. 97%, P=0.99) following BMS and BP-SES implantation, respectively.
This study demonstrates the low early thrombogenicity of a BP-SES implanted in an aortic rat model, which did not differ from a BMS. These data could be helpful to support the safety of a shortened 1-month DAPT duration following BP-SES implantation in the human coronary artery.
尽管裸金属支架(BMS)植入患者的1个月双联抗血小板治疗(DAPT)已得到充分确立,但药物洗脱支架(DES)植入后DAPT的最佳持续时间仍存在争议。由于担心支架血栓形成风险,缩短DAPT的安全性正在研究中。关于生物可吸收聚合物西罗莫司洗脱支架(BP-SES)植入后体内血小板活化和促血栓形成反应的数据很少。
我们研究的目的是在主动脉大鼠模型中比较BP-SES与BMS的早期血栓形成性。
总体而言,30只大鼠在腹主动脉接受支架植入:比较BMS(动力支架;N = 15)和BP-SES(Ultimaster Tansei;N = 15)的早期血栓形成性。随着时间的推移,BMS和BP-SES之间血小板表面的CD62P暴露和整合素受体处的纤维蛋白原结合没有差异。在第28天,两组支架的血栓覆盖率同样低(0 vs. 0.1%,P = 0.84);血栓沉积物在第84天完全消失。分别在BMS和BP-SES植入后1个月(90 vs. 95%,P = 0.64)和3个月(87 vs. 97%,P = 0.99)时,内皮支柱覆盖率同样高。
本研究表明,在主动脉大鼠模型中植入的BP-SES早期血栓形成性较低,与BMS无差异。这些数据可能有助于支持在人类冠状动脉中植入BP-SES后缩短1个月DAPT持续时间的安全性。