title: Morphological, Functional, and Biological Vascular Healing Response 6 Months After Drug-Eluting Stent Implantation: A Randomized Comparison of Three Drug-Eluting Stents.
abstract: OBJECTIVE
  This study evaluated coronary endothelial function after the implantation of sirolimus-eluting stents (SESs), everolimus-eluting stents (EESs), and zotarolimus-eluting stents (ZES) by a different methodology, and also analyzed whether optical coherence tomography (OCT) findings represent endothelial healing after stenting.
  
  
  BACKGROUND
  It is unclear whether OCT assessment of stent strut coverage represents endothelial healing after drug-eluting stent implantation.
  
  
  METHODS
  Thirty patients with a left anterior descending artery lesion were randomized 1:1:1 to receive an SES, EES, or ZES. The vascular response was evaluated 6 months after stenting by three methods: the functional response by acetylcholine infusion, the morphological response by OCT, and the biological response by measuring vascular endothelial growth factor (VEGF) levels.
  
  
  RESULTS
  The proportion of uncovered struts by OCT at 6 months was significantly higher in both SES and EES than in ZES. However, the vasomotor response was impaired and the VEGF level of the coronary sinus was significantly lower in SES than in EES and ZES. There were no relationships between the OCT findings and vasomotor response to acetylcholine and VEGF levels in all cohorts.
  
  
  CONCLUSIONS
  The vascular response at 6 months was more preserved in ZES and EES than in SES. Our results suggest that the morphological assessment with OCT may not always be used as a surrogate for functional and biological healing response after stenting. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Nakata
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan. kfujii@hyo-med.ac.jp.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukunaga
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shibuya
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kawai
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Daizo
authors.initials: D
authors.lastname: Kawasaki
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Naito
authors.affiliation: Division of Coronary Heart Disease, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Ohyanagi
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Masuyama
mesh_terms: D000109:Acetylcholine / Q000008:administration & dosage; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D054855:Drug-Eluting Stents; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D000068338:Everolimus / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011446:Prospective Studies; D011474:Prosthesis Design; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D014664:Vasodilation / Q000187:drug effects*; D014665:Vasodilator Agents / Q000008:administration & dosage; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D015415:Biomarkers; D002317:Cardiovascular Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D014665:Vasodilator Agents; D000068338:Everolimus; C489443:zotarolimus; D000109:Acetylcholine; D020123:Sirolimus
keywords: coronary artery disease; drug-eluting stents; optical coherence tomography