title: Effect of pretreatment of ezetimibe/simvastatin on arterial healing and endothelialization after drug-eluting stent implantation in a porcine coronary restenosis model.
abstract: OBJECTIVE
  We sought to evaluate the effect of the early use of ezetimibe/simvastatin (Vytorin®) on arterial healing and endothelialization after the implantation of a drug-eluting stent (DES) in a porcine model of coronary restenosis.
  
  
  METHODS
  A total of 20 pigs (40 coronary arteries) were randomly allocated to a pretreatment or no treatment group. The pretreatment group (n=20) received oral ezetimibe/simvastatin (10/20 mg) daily for 7 days before stenting and the no pretreatment group (n=20) did not. All pigs were treated with ezetimibe/simvastatin (10/20 mg) daily after stenting for 4 weeks. Stenting was performed using a bare-metal stent (BMS, n=10) and three types of DES: biolimus A9-eluting stent (BES, n=10), zotarolimus-eluting stent (ZES, n=10), and everolimus-eluting stents (EES, n=10). Four weeks later, pigs underwent a follow-up coronary angiography and were sacrificed for histopathologic analysis.
  
  
  RESULTS
  There were no significant differences between the pretreatment and no pretreatment groups in the internal elastic lamina area, lumen area, neointima area, stenotic area, injury score, fibrin score, and inflammation score. In both groups, the fibrin score was higher in pigs with DES than in BMS, particularly in ZES and EES. The inflammatory score was not different between DES and BMS.
  
  
  CONCLUSIONS
  In a porcine model of coronary restenosis, pretreatment with ezetimibe/simvastatin before DES implantation failed to improve arterial healing and endothelialization compared to treatment after stenting.
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Doo Sun
authors: DS
authors: Sim
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Myung Ho
authors: MH
authors: Jeong
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Dae Sung
authors: DS
authors: Park
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Jung Ha
authors: JH
authors: Kim
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Kyung Seob
authors: KS
authors: Lim
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Hyun Kuk
authors: HK
authors: Kim
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Sung Soo
authors: SS
authors: Kim
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Jae Yeong
authors: JY
authors: Cho
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Hae Chang
authors: HC
authors: Jeong
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Keun Ho
authors: KH
authors: Park
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Young Joon
authors: YJ
authors: Hong
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Ju Han
authors: JH
authors: Kim
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Youngkeun
authors: Y
authors: Ahn
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Jeong Gwan
authors: JG
authors: Cho
authors: The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health, Welfare and Family Affairs, Gwangju, Korea.
authors: Jong Chun
authors: JC
authors: Park
keywords: Coronary restenosis; Drug-eluting stents; Ezetimibe; Hydroxymethylglutaryl-CoA reductase inhibitors