title: Comparison of endothelium-dependent and -independent vasomotor response after abluminal biodegradable polymer biolimus-eluting stent and persistent polymer everolimus-eluting stent implantation (COMPARE-IT).
abstract: BACKGROUND
  Drug-eluting stents (DES) have been associated with local endothelial dysfunction in the segments proximal and distal to the stent (peristent segments) and increased thrombotic risk in long term follow-up. Little data exists on endothelial function post-implantation of new DES with biodegradable polymer. The aim of our study was to compare the local endothelial function assessed by exercise induced coronary vasomotion after implantation of a biolimus A9-eluting stent with biodegradable polymer (BES) with an everolimus-eluting stent with durable polymer (EES).
  
  
  METHODS
  Coronary vasomotion was evaluated with quantitative coronary angiography at rest and during supine bicycle exercise in nine patients with EES and thirteen patients with BES, 16 months after stent implantation. Mean luminal diameter of the stent, peristent segments, and of a control vessel were determined at rest, during exercise, and after the administration of nitroglycerine.
  
  
  RESULTS
  The control vessel showed exercise-induced vasodilatation in both groups (EES: +6.4±5.5%, p=0.07; BES: +7.8±10.1%, p=0.07). Vasomotion in the stented vessel segment was abolished. There was exercise-induced vasoconstriction in both groups in the segments proximal (EES: -9.6±4.5%; p=0.03; BES: -4.3±5.4%, p=0.02) and distal to the stent (EES: -3.2±9.3%; p=0.41, BES -8.6±8.0%, p<0.01). Sublingual nitroglycerin was associated with maximal vasodilatation of the peristent segments in both groups.
  
  
  CONCLUSIONS
  Alike DES with durable polymer, stents with a biodegradable polymer are associated with exercise-induced paradoxical coronary vasoconstriction of the peristent segments. This data suggests that endothelial dysfunction after DES implantation is not primarily caused by the durability of the polymer coating.
authors.affiliation: Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland; Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands. Electronic address: serbanpuricel@icloud.com.
authors.forename: Serban
authors.initials: S
authors.lastname: Puricel
authors.affiliation: Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland; Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.
authors.forename: Zacharenia
authors.initials: Z
authors.lastname: Kallinikou
authors.affiliation: Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland; Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.
authors.forename: Jaqueline
authors.initials: J
authors.lastname: Espinola
authors.affiliation: Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland; Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.
authors.forename: Diego
authors.initials: D
authors.lastname: Arroyo
authors.affiliation: Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland; Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Goy
authors.affiliation: Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland; Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Stauffer
authors.affiliation: Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland; Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.
authors.forename: Gérard
authors.initials: G
authors.lastname: Baeriswyl
authors.affiliation: Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland; Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.
authors.forename: Pieter Cornelis
authors.initials: PC
authors.lastname: Smits
authors.affiliation: Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland; Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Cook
authors.affiliation: Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland; Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.
authors.forename: Mario
authors.initials: M
authors.lastname: Togni
mesh_terms: D020341:Absorbable Implants / Q000639:trends*; D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D054855:Drug-Eluting Stents / Q000639:trends*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000601:surgery; D000068338:Everolimus / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011108:Polymers / Q000008:administration & dosage*; D011446:Prospective Studies; D011859:Radiography; D016037:Single-Blind Method; D014661:Vasoconstriction / Q000187:drug effects / Q000502:physiology; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology; D014666:Vasomotor System / Q000000981:diagnostic imaging* / Q000187:drug effects
chemical_list: D011108:Polymers; D000068338:Everolimus
keywords: Biolimus-eluting stent; Coronary artery disease; Endothelial function; Everolimus-eluting stent