title: Sirolimus-eluting stents suppress neointimal formation irrespective of metallic allergy.
abstract: BACKGROUND
  Metallic allergy is associated with restenosis following bare metal stent implantation, but the impact of metallic allergy on the outcome after implantation of drug-eluting stents (DES) has not been investigated.
  
  
  RESULTS
  The present study group consisted of 88 consecutive patients (109 lesions) who underwent percutaneous coronary intervention with sirolimus-eluting stents (SES). Follow-up angiography was obtained at 8 months in all patients. At that time, the patients underwent epicutaneous patch tests for nickel, chromate, molybdenum, manganese, and titanium, which were evaluated after 48 h of contact. The patch test was positive in 14 patients (16%) (5 for manganese, 3 for nickel, 1 for chromate, 1 for Nickel and manganese, and 4 for manganese and chromate). The binary restenosis rate in the patients with a positive patch test was similar to those with negative patch test (6.3% vs 6.5%, p=0.98). Serial quantitative coronary angiography analyses identified no significant differences in late lumen loss of in-stent segments between patients with positive patch test and those with negative patch test (0.19+/-0.49 mm vs 0.12+/-0.48 mm, p=0.55).
  
  
  CONCLUSIONS
  SES prevent restenosis irrespective of metallic allergy. The classic relationship between metallic allergy and in-stent restenosis, seen with bare metal stents, does not appear to arise with DES, possibly because of the immunosuppressive effect of sirolimus.
authors.affiliation: Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
authors.forename: Gaku
authors.initials: G
authors.lastname: Nakazawa
authors.forename: Kengo
authors.initials: K
authors.lastname: Tanabe
authors.forename: Jiro
authors.initials: J
authors.lastname: Aoki
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Yasutomi
authors.initials: Y
authors.lastname: Higashikuni
authors.forename: Hirosada
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Shuji
authors.initials: S
authors.lastname: Ohtsuki
authors.forename: Sen
authors.initials: S
authors.lastname: Yachi
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Yagishita
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hara
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D002840:Chromates / Q000276:immunology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000276:immunology / Q000628:therapy*; D023903:Coronary Restenosis / Q000276:immunology / Q000517:prevention & control; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008345:Manganese / Q000276:immunology; D008670:Metals / Q000276:immunology*; D008875:Middle Aged; D008982:Molybdenum / Q000276:immunology; D009532:Nickel / Q000276:immunology; D010328:Patch Tests; D020123:Sirolimus / Q000008:administration & dosage*; D014025:Titanium / Q000276:immunology; D016896:Treatment Outcome; D017539:Tunica Intima / Q000276:immunology
chemical_list: D002840:Chromates; D007166:Immunosuppressive Agents; D008670:Metals; D008345:Manganese; D009532:Nickel; D008982:Molybdenum; D014025:Titanium; D020123:Sirolimus