The impact of triple anti-platelet therapy for endothelialization and inflammatory response at overlapping bioabsorbable polymer coated drug-eluting stents in a porcine coronary model.
BACKGROUND
This study was conducted to evaluate the endothelialization and the inflammatory responses depending on the administration duration of triple anti-platelet therapy at overlapping bioabsorbable polymer coated biolimus-eluting stents (BESs) in a porcine coronary model.


METHODS
We successfully deployed 36 overlapping BESs for the left anterior descending coronary and left circumflex artery or right coronary artery in 18 non-injured pigs. Total pigs were divided into 3 groups (12 overlapping stents of 6 pigs in each group) as follows: group I received aspirin 100mg and clopidogrel 75 mg daily for 8 weeks, group II received aspirin 100mg and clopidogrel 75 mg daily for 8 weeks and cilostazol 200mg daily for initial 4 weeks, and group III received aspirin 100mg, clopidogrel 75 mg, and cilostazol 200mg daily for 8 weeks. Follow-up coronary angiograms and histomorphometric and histopahtologic analyses at overlapping and non-overlapping segments were performed respectively.


RESULTS
Inflammation score was similar between overlapping and non-overlapping segments in all pigs (1.2 ± 0.33 vs. 1.1 ± 0.17, p=0.117). The neointima area (NA) and percent area stenosis (%AS) at overlapping segments were not significantly different among the 3 groups. However, at non-overlapping segments, NA and %AS in group III were significantly smaller than those in group I (2.3 ± 0.50mm(2) vs. 1.8 ± 0.43 mm(2), p=0.037; 48.9 ± 12.85% vs. 37.7 ± 9.08%, p=0.031).


CONCLUSIONS
Our study shows that BES appears to be reliable on the inflammatory response at overlapping segments as well as non-overlapping segments. Long-term administration of cilostazol is more effective in reducing neointimal formation at non-overlapping segments of BESs in a porcine coronary model.
The Heart Center of Chonnam National University Hospital, South Korea; The Heart Research Center of Designated by Korea Ministry of Health and Welfare, South Korea.
Keun-Ho
KH
Park
Myung Ho
MH
Jeong
Jong Min
JM
Kim
Dae Sung
DS
Park
Jung Ha
JH
Kim
Kyung Seob
KS
Lim
Ki Hong
KH
Lee
Doo Sun
DS
Sim
Hyun Ju
HJ
Yoon
Nam Sik
NS
Yoon
Kye Hun
KH
Kim
Hyung Wook
HW
Park
Young Joon
YJ
Hong
Ju Han
JH
Kim
Youngkeun
Y
Ahn
Jeong Gwan
JG
Cho
Jong Chun
JC
Park
Jung Chaee
JC
Kang
D020341:Absorbable Implants; D000818:Animals; D001241:Aspirin / Q000627:therapeutic use*; D000077407:Cilostazol; D000077144:Clopidogrel; D020099:Coated Materials, Biocompatible; D023903:Coronary Restenosis / Q000473:pathology / Q000517:prevention & control*; D003331:Coronary Vessels / Q000187:drug effects / Q000473:pathology; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D054855:Drug-Eluting Stents; D005260:Female; D007249:Inflammation / Q000473:pathology / Q000517:prevention & control*; D058426:Neointima / Q000188:drug therapy / Q000473:pathology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011108:Polymers; D013552:Swine; D013777:Tetrazoles / Q000627:therapeutic use*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D010975:Platelet Aggregation Inhibitors; D011108:Polymers; D013777:Tetrazoles; D000077144:Clopidogrel; D000077407:Cilostazol; D013988:Ticlopidine; D001241:Aspirin
Cilostazol; Drug-eluting stents; Inflammation; Restenosis