title: Serial changes of coronary endothelial function and arterial healing after paclitaxel-eluting stent implantation.
abstract: Several studies have shown coronary endothelial dysfunction and delayed arterial healing associated with first-generation drug-eluting stents. However, it remains unclear whether those issues persist for a longer term. We thus evaluated serial changes in endothelial function and intra-stent condition after paclitaxel-eluting stents (PES) implantation. Eight patients with stable effort angina were assessed at 9 and over 24 months (1st and 2nd follow-up) after PES implantation. Endothelial function was evaluated with intracoronary infusion of acetylcholine (Ach). Vascular responses were quantitatively measured. Intra-stent condition was evaluated using angioscopy. We assessed (1) the degree of neointimal coverage over the stent (grade 0: no coverage to grade 3: full coverage); (2) presence of yellow intima inside the stent, and (3) existence of in-stent thrombus. Vasomotions proximal to the stent at 2nd follow-up significantly improved compared with 1st follow-up (p = 0.04), whereas vascular responses at the distal segment did not differ between 1st and 2nd follow-up (p = 0.19). From the angioscopic study, the average of coverage grading was comparable between the 2 points (0.9 ± 0.8 vs. 1.3 ± 1.0, p = 0.20). In addition, the incidence of yellow intima and in-stent thrombus did not differ between 1st and 2nd follow-up (yellow intima; 50 vs. 37.5 %, p = 1.0, thrombus; 75 vs. 50 %, p = 0.61). Endothelial dysfunction and delayed healing with PES could attenuate gradually, but these issues may persist over 24 months in some patients.
authors.affiliation: Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan. mitsutake_yoshiaki@kurume-u.ac.jp.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Mitsutake
authors.affiliation: Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ueno
authors.affiliation: Division of Cardiovascular Medicine, Stanford University, Stanford, USA.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Ikeno
authors.affiliation: Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Yokoyama
authors.affiliation: Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Sasaki
authors.affiliation: Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.
authors.forename: Takaharu
authors.initials: T
authors.lastname: Nakayoshi
authors.affiliation: Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Itaya
authors.affiliation: Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Chibana
authors.affiliation: Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sasaki
authors.affiliation: Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Fukumoto
mesh_terms: D000109:Acetylcholine; D000368:Aged; D060050:Angina, Stable / Q000628:therapy; D017546:Angioscopy; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000628:therapy; D023921:Coronary Stenosis / Q000628:therapy; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents; D004730:Endothelium, Vascular / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin; D017239:Paclitaxel / Q000008:administration & dosage*; D062645:Percutaneous Coronary Intervention; D017539:Tunica Intima / Q000473:pathology; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin; D000109:Acetylcholine; D017239:Paclitaxel
keywords: Coronary angioscopy; Drug-eluting stent; Endothelial function