Effect of Stents Coated with Artemisinin or Dihydroartemisinin in a Porcine Coronary Restenosis Model.
OBJECTIVE
Artemisinin and dihydroartemisinin are drugs used to treat malaria. These drugs suppress inflammatory reactions. The aim of this study was to examine the anti-intima hyperplasia effect of a novel drug-eluting stent with artemisinin or dihydroartemisinin in a porcine coronary restenosis model.


METHODS
Pigs were randomized into four groups; in the first, the coronary arteries (20 pigs, a total of 40 coronary arteries, with 10 coronary arteries in each group) was implanted with bare metal stents (BMS, n=10); the second group was given polymer-coated stents (PCS, n=10); the third group was treated with artemisinin-eluting stents (AES, n=10); and the fourth group was given dihydroartemisinin-eluting stents (DAES, n=10). Histopathologic analysis was performed 28 days after stenting.


RESULTS
The injury and fibrin scores among the four groups were not significantly different. However, the internal elastic lamina, lumen area, and neointima area were significantly different. Moreover, the percent area of stenosis (46.2±18.66% in BMS vs. 89.4±10.92% in PCS vs. 83.3±17.07% in AES vs. 36.7±11.20% in DAES, p<0.0001) and inflammation score (1.0 [range: 1.0-1.0] vs. 3.0 [range: 2.25-3.0] vs. 3.0 [range: 1.0-3.0] vs. 2.0 [range: 1.75-3.0] in BMS, PCS, AES, and DAES, respectively; p<0.001) were markedly decreased in the DAES group compared to the PCS group.


CONCLUSIONS
DES, which uses a natural substance, dihydroartemisinin, showed a neointima and inflammatory suppressive effect in a porcine coronary restenosis model.
Korea Cardiovascular Stent Research Institute, Jangsung, Korea.; Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea.
Suyoung
S
Jang
Korea Cardiovascular Stent Research Institute, Jangsung, Korea.; Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea.; Regeneromics Research Center, Chonnam National University, Gwangju, Gwangju, Korea.
Myung Ho
MH
Jeong
Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea.
Kyung Seob
KS
Lim
Korea Cardiovascular Stent Research Institute, Jangsung, Korea.; Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.
In Ho
IH
Bae
Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea.
Jun-Kyu
JK
Park
Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea.
Dae Sung
DS
Park
Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea.
Jae Won
JW
Shim
Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea.
Jung Ha
JH
Kim
Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.
Hyun Kuk
HK
Kim
Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea.
Doo Sun
DS
Sim
Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea.
Young Joon
YJ
Hong
Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea.
Youngkeun
Y
Ahn
Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea.; Cardiovascular Research Center, Chonnam National University Hospital, Gwangju, Korea.
Jung Chaee
JC
Kang
Coronary restenosis; Inflammation; Stents