Oh Seok, Kim Ju Han, Ahmad Saleem, Jin Yu Jeong, Na Mi Hyang, Kim Munki, Kim Jeong Ha, Park Dae Sung, Hyun Dae Young, Cho Kyung Hoon, Kim Min Chul, Sim Doo Sun, Hong Young Joon, Lee Seung-Won, Ahn Youngkeun, Jeong Myung Ho
Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
The Cardiovascular Convergence Research Center of Chonnam National University Hospital Designated by the Korean Ministry of Health and Welfare, Gwangju, Korea.
Korean Circ J. 2025 Jan;55(1):50-64. doi: 10.4070/kcj.2024.0171. Epub 2024 Sep 30.
Cigarette smoking is a major risk factor for atherosclerosis. Nicotine, a crucial constituent of tobacco, contributes to atherosclerosis development and progression. However, evidence of the association between nicotine and neointima formation is limited. We aimed to evaluate whether nicotine enhances neointimal hyperplasia in the native epicardial coronary arteries of pigs after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).
After coronary angiography (CAG) and quantitative coronary angiography (QCA), we implanted 20 DES into 20 pigs allocated to 2 groups: no-nicotine (n=10) and nicotine (n=10) groups. Post-PCI CAG and QCA were performed immediately. Follow-up CAG, QCA, optical coherence tomography (OCT), and histopathological analyses were performed 2 months post-PCI.
Despite intergroup similarities in the baseline QCA findings, OCT analysis showed that the nicotine group had a smaller mean stent and lumen areas, a larger mean neointimal area, greater percent area stenosis, and higher peri-strut fibrin and inflammation scores than the no-nicotine group. In immunofluorescence analysis, the nicotine group displayed higher expression of CD68 and α-smooth muscle actin but lower CD31 expression than the no-nicotine group.
Nicotine inhibited re-endothelialization and promoted inflammation and NIH after PCI with DES in a porcine model.
吸烟是动脉粥样硬化的主要危险因素。尼古丁作为烟草的关键成分，促进动脉粥样硬化的发生和发展。然而，尼古丁与新生内膜形成之间关联的证据有限。我们旨在评估尼古丁是否会在猪经皮冠状动脉介入治疗（PCI）并植入药物洗脱支架（DES）后，增强其天然心外膜冠状动脉的新生内膜增生。
在进行冠状动脉造影（CAG）和定量冠状动脉造影（QCA）后，我们将20个DES植入20只猪体内，这些猪被分为两组：无尼古丁组（n = 10）和尼古丁组（n = 10）。PCI术后立即进行CAG和QCA。PCI术后2个月进行随访CAG、QCA、光学相干断层扫描（OCT）以及组织病理学分析。
尽管两组在基线QCA结果上相似，但OCT分析显示，与无尼古丁组相比，尼古丁组的平均支架和管腔面积更小，平均新生内膜面积更大，面积狭窄百分比更高，支架周围纤维蛋白和炎症评分更高。在免疫荧光分析中，尼古丁组的CD68和α平滑肌肌动蛋白表达高于无尼古丁组，但CD31表达低于无尼古丁组。
在猪模型中，尼古丁在DES PCI术后抑制了再内皮化，促进了炎症和新生内膜增生。
