Key result
Sirolimus-eluting stents are linked to impaired coronary endothelial function compared to conventional PCI.
Why the study?
Several invasive studies reported delayed reendothelialization and endothelial dysfunction following sirolimus-eluting stent implantation, but noninvasive evaluation was needed.
Does sirolimus-eluting stent implantation reduce coronary endothelial function compared to conventional PCI in lesions undergoing PCI?
Observational (n=14)
Does sirolimus-eluting stent implantation reduce coronary endothelial function compared to conventional PCI in lesions undergoing PCI?
Sirolimus-eluting stent implantation is associated with coronary endothelial dysfunction in distal segments, which can be evaluated noninvasively using PET and cold pressor testing.
Noninvasive PET-CPT may assess post-SES endothelial function without catheterization; leaves open validation in larger prospective cohorts before clinical use.
OBJECTIVE: Several invasive studies have reported delayed reendothelialization and endothelial dysfunction following sirolimus-eluting stent (SES) implantation. We evaluated the changes in coronary endothelial function following SES implantation by using a noninvasive method that involved positron emission tomography and cold pressor testing (CPT). METHODS: The study was conducted on 14 lesions on which percutaneous coronary intervention (PCI) was successively performed. The lesions were classified into 2 groups depending on the PCI performed: the conventional PCI group, in which 7 conventional PCIs (plain old balloon angioplasty or bare-metal stents) were performed, and the SES group, in which 7 SESs were implanted. Coronary endothelial function was defined as the percent increase in the myocardial blood flow (MBF) during CPT. RESULTS: The resting MBF in the segments distal to the PCI sites did not differ between the conventional PCI and SES groups; however, the MBF significantly decreased in the SES group during CPT. CONCLUSIONS: These data suggest that SES implantation induces coronary endothelial dysfunction in the segments distal to the PCI sites.
No takes yet. Share an insight, caveat, or question.
Horigome et al. (2009) conducted an observational in Coronary lesions requiring percutaneous coronary intervention (n=14). Sirolimus-eluting stent (SES) implantation vs. Conventional PCI (plain old balloon angioplasty or bare-metal stents) was evaluated on Percent increase in myocardial blood flow during cold pressor testing. Sirolimus-eluting stent implantation significantly decreased myocardial blood flow during cold pressor testing compared to conventional PCI, indicating coronary endothelial dysfunction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: