A prospective, randomized, 6-month comparison of the coronary vasomotor response associated with a zotarolimus- versus a sirolimus-eluting stent: differential recovery of coronary endothelial dysfunction.
OBJECTIVE
We prospectively compared coronary endothelial dysfunction in patients with zotarolimus-eluting stent (ZES) versus sirolimus-eluting stent (SES) implantation at 6-month follow-up.


BACKGROUND
A ZES has been associated with uniform and rapid healing of the endothelium.


METHODS
Fifty patients were randomly treated with intravascular ultrasound-guided stenting with a single stent to the mid-segment of the left anterior descending artery (20 ZES, 20 SES, and 10 bare-metal stents), and endothelial function was estimated before and after intervention at 6-month follow-up by incremental acetylcholine (Ach) (10, 20, 50, and 100 microg/min) and nitrate (200 microg/min) infusions into the left coronary ostium. The vascular response was quantitatively measured in the 5-mm segments proximal and distal to the stent.


RESULTS
In the drug-eluting stent groups, more intense vasoconstriction to incremental doses of Ach was observed at 6-month follow-up compared with the responses before stenting. Endothelial function associated with the ZES was more preserved at 6-month follow-up compared with the SES. Vasoconstriction to Ach was more prominent in the distal segments than the proximal segments in both the ZES and SES groups. Endothelium-independent vasodilation to nitrate did not differ significantly among the study groups.


CONCLUSIONS
Vasoconstriction in response to Ach in the peri-stent region was less pronounced in the ZES group than the SES group at 6-month follow-up, which suggests that endothelial function associated with ZES can be more preserved than the SES.
Kim
Jin Won
JW
Cardiovascular Center, Korea University, Guro Hospital, Seoul, Korea.
Seo
Hong Seog
HS
Park
Jae Hyoung
JH
Na
Jin Oh
JO
Choi
Cheol Ung
CU
Lim
Hong Euy
HE
Kim
Eung Ju
EJ
Rha
Seung-Woon
SW
Park
Chang Gyu
CG
Oh
Dong Joo
DJ
D023903:Coronary Restenosis / Q000188:drug therapy* / Q000517:prevention & control; D003331:Coronary Vessels / Q000187:drug effects / Q000503:physiopathology*; D054855:Drug-Eluting Stents; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D013997:Time Factors; D014661:Vasoconstriction / Q000187:drug effects
D007166:Immunosuppressive Agents; C489443:zotarolimus; D020123:Sirolimus