title: Bioabsorbable polymer-coated sirolimus-eluting stent implantation preserves coronary vasomotion: A DESSOLVE II trial sub-study.
abstract: OBJECTIVE
  We studied coronary vasomotion in patients treated with the Mistent(®) absorbable polymer sirolimus-eluting stent (APSES) and in patients implanted with the Endeavor(®) zotarolimus-eluting stent (ZES).
  
  
  BACKGROUND
  First generation (1st-gen) drug-eluting stents (DES) induce persistent vasomotor dysfunction in the treated coronary artery. It is unknown whether and to what extent the implantation of an absorbable polymer DES impairs coronary vasomotion.
  
  
  METHODS
  This sub-study of the DESSOLVE II trial included 19 APSES Mistent(®) and 10 ZES Endeavor(®) patients. Incremental atrial pacing and quantitative coronary angiography were used to assess vasomotion proximal and distal to the stent and in a reference segment at 9 months after implantation. Percent changes in vessel diameter with pacing versus baseline were calculated and compared. Vasomotor response of the APSES group was also compared with changes observed in a historical group of 17 patients implanted with a 1st-gen sirolimus-eluting stent (SES).
  
  
  RESULTS
  Normal vasomotion (vasodilatation) was preserved and of comparable magnitude in the APSES and in the ZES group both proximally (P = 0.34) and distally (P = 0.38) to the stent. This finding was not observed in the 1st-gen SES group showing marked pacing-induced vasoconstriction at both stent edges (P < 0.05 vs. APSES). The results were practically unchanged after excluding patients with absolute changes in vessel diameter <3% between baseline and maximal pacing.
  
  
  CONCLUSIONS
  The implantation of an absorbable polymer sirolimus-eluting stent is associated with preserved coronary vasomotion, comparable to that observed after implantation of the Endeavor(®) ZES, and distinct from 1st-gen SES which induce coronary vasomotor dysfunction.
authors.affiliation: Cardiovascular Research Center Aalst, OLV Clinic, Aalst, Belgium.
authors.forename: Dan
authors.initials: D
authors.lastname: Rusinaru
authors.affiliation: Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Mathias
authors.initials: M
authors.lastname: Vrolix
authors.affiliation: Antwerp Hospital, Antwerp, Belgium.
authors.forename: Stefan
authors.initials: S
authors.lastname: Verheye
authors.affiliation: South Manchester University Hospital, Manchester, United Kingdom.
authors.forename: Saqib
authors.initials: S
authors.lastname: Chowdhary
authors.affiliation: Brussels University Hospital, Brussels, Belgium.
authors.forename: Danny
authors.initials: D
authors.lastname: Schoors
authors.affiliation: NIHR Cardiovascular Research Unit, Royal Brompton Hospital & Imperial College, London, United Kingdom.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.affiliation: Department of Cardiovascular Diseases, UZ Leuven, Belgium.
authors.forename: Walter
authors.initials: W
authors.lastname: Desmet
authors.affiliation: Micell Technologies, Durham, North Carolina.
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Donohoe
authors.affiliation: Auckland City Hospital, Auckland, New Zealand.
authors.forename: John A
authors.initials: JA
authors.lastname: Ormiston
authors.affiliation: Micell Technologies, Durham, North Carolina.
authors.forename: Charlene
authors.initials: C
authors.lastname: Knape
authors.affiliation: Case Medical Center, Cleveland, Ohio.
authors.forename: Hiram
authors.initials: H
authors.lastname: Bezerra
authors.affiliation: Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lansky
authors.affiliation: Cardiovascular Research Center Aalst, OLV Clinic, Aalst, Belgium.
authors.forename: William
authors.initials: W
authors.lastname: Wijns
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D002304:Cardiac Pacing, Artificial; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D054855:Drug-Eluting Stents; D005060:Europe; D005260:Female; D065386:Historically Controlled Study; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011108:Polymers; D011446:Prospective Studies; D016037:Single-Blind Method; D020123:Sirolimus / Q000008:administration & dosage* / Q000031:analogs & derivatives; D013997:Time Factors; D016896:Treatment Outcome; D014661:Vasoconstriction; D014664:Vasodilation
chemical_list: D002317:Cardiovascular Agents; D011108:Polymers; C489443:zotarolimus; D020123:Sirolimus
keywords: coronary angiography; coronary stenting; endothelial function