Key result
ZES linked to ~50% less peri-stent vasoconstriction than PES at 9 months.
Why the study?
Does Zotarolimus-eluting stent improve endothelial function and re-endothelialization compared to Paclitaxel-eluting stent in patients with coronary artery disease?
Cohort (n=14)
No
Does Zotarolimus-eluting stent improve endothelial function and re-endothelialization compared to Paclitaxel-eluting stent in patients with coronary artery disease?
Absolute Event Rate: 28.6% vs 57.1%
p-value: p=<0.01
Zotarolimus-eluting stents may promote better vessel healing and preserve endothelial function compared to first-generation paclitaxel-eluting stents.
Zotarolimus-eluting stents were associated with less vasoconstriction than paclitaxel-eluting stents; leaves open whether surrogate improvements affect clinical outcomes.
BACKGROUND: Several studies have reported re-endothelialization and endothelial function after drug-eluting stent (DES) implantation; however, the relationship between re-endothelialization and endothelial function after DES implantation has not been investigated yet. METHODS: A total of 14 patients underwent evaluation of re-endothelialization by optical coherence tomography (OCT) and endothelial function by incremental Ach infusion at 9 months after DES implantation (ZES: N = 7, PES: N = 7). The neointimal thickness (NIT) inside each strut, strut coverage, and malapposition at every 1 mm cross-section were evaluated by OCT and the endothelial function was estimated by measuring the coronary vaso-reactivity in response to acetylcholine (Ach) infusion into coronary arteries. RESULTS: Zotarolims eluting stent (ZES), compared with paclitaxcel eluting stent (PES), showed more homogeneous neointimal coverage of stent struts and low rate of malapposition. Vasoconstriction in response to Ach in the peri-stent region was also less pronounced in ZES than PES. In particular, vasoconstriction was more often observed in cases with inhomogeneous neointimal coverage of stent struts in the PES group. CONCLUSIONS: Our findings suggest that endothelial function seems to be better preserved with ZES than PES, and homogeneous neointimal coverage of stent struts seem to be associated with the preserved endothelial function.
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Murase et al. (2013) conducted a cohort in Stable or unstable coronary syndromes with de novo single lesion (n=14). Zotarolimus-eluting stent (ZES) vs. Paclitaxel-eluting stent (PES) was evaluated on Vasoconstriction (spasm) in response to acetylcholine in the peri-stent region (p=<0.01). Zotarolimus-eluting stents were associated with significantly less acetylcholine-induced vasoconstriction (28.6% vs 57.1%, p<0.01) and greater neointimal coverage compared to paclitaxel-eluting stents at 9 months.
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