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Aims: Endothetial dysfunction has been related both to progression of atheros clerotic disease and to future cardiovascular events. We assessed local epicardial endothelial function 6 months after sirolimus-eluting stent(SES) or bare metal stent(BS) implantation. Methods and results: In 12 patients(seven SES, five BS), endothelium-depen- dent vasomotion of a coronary segment 15 mm in length, starting 2 mm distal to the stent, was assessed with quantitative coronary angiography immediately after the procedure and at 6 months follow-up, after intracoronary infusion of acetylcholine. Intravascular ultrasound(IVUS) was performed and coronary flow reserve(CFR) assessed in all patients. At follow-up significant vasoconstriction was seen in SES(median 32% diameter reduction from baseline) but not in BS(median 2% reduction) patients after acetylcholine infusion(P=0.03 for SES vs. BS); endothelium-independent vasodilatation to nitrates did not differ significantly between groups(20% SES, 5% BS, P=0.14). IVUS revealed no late unhealed dissections and CFR was comparable between groups(SES 3.1 vs. BS 3.2, n.s.). Conclusion: SES implantation may have an adverse effect on local endothelium-dependent vasomotor responses compared with BS implantation at 6 months. Long-term clinical consequences of this observation are still unknown.
We assessed local epicardial endothelial function for 6 months after sirolimus-eluting stent (SES) or bare metal stent (BS) implantation. Methods and results: In 12 patients (seven SES, five BS), endothelium-dependent-dent vasomotion of a coronary segment 15 mm in length, starting 2 mm distal to the stent, was assessed with quantitative coronary angiography immediately after the procedure and at 6 months follow-up , after intracoronary infusion of acetylcholine. Intravascular ultrasound (IVUS) was performed and coronary flow reserve (CFR) assessed in all patients. At follow-up significant vasoconstriction was seen in SES (median 32% diameter reduction from baseline) but not in BS median 2% reduction) patients after acetylcholine infusion (P = 0.03 for SES vs. BS); endothelium-independent vasodilatation to nitrates did not differ significantly between groups (20% SES, 5% BS, P = 0.14). IVUS revealed no late unhealed dissections and CFR was comparable between groups (SES 3.1 vs. BS 3.2, ns). Conclusion: SES implantation may have an adverse effect on local endothelium-dependent vasomotor responses compared with BS implantation at 6 months. Long-term clinical consequences of this observation are still unknown.