Prosepective randomized six-month comparison of coronary vasomotor response associated with zotarolimus-versus sirolimus-eluting stent: Differential recovery of coronary endothelial dysfunction

초록

Background: Zotarolimus-eluting stent(ZES: EndeavorTM) have been known to carry a lower risk of stent thrombosis due to rapid re-endothelialization. Objective: We prospectivley comapred the coronary endothelial dysfunction in patients with a Zotarolimus- versus Sirolimus-eluting stent (SES: CypherTM) implantation at 6 months follow-up. Methods: In 55 patients (male 21, 54.7±9.5 yrs) randomly treated with IVUS guided intervention using single stent to the mid segment of left anterior descending artery (20 ZES, 20 SES, 15 BMS: bare metal stent: DriverTM), endothelial function was estimated at pre-intervention and post-intervention 6 months follow-up, by incremental acetylcholine (Ach1 :10, Ach2: 20, Ach3: 50, Ach4: 100 Μg/min) and nitrate (200 Μg/ min) infusion into the left coronary ostium. The vascular response was quantitatively measured in the segment 5 mm proximal and distal to stent. All anti-anginal agents were withheld for at least 72 hours prior to coronary angiography. Results: At 6 months follow-up, significant vasoconstriction to Ach was observed in DES groups over the BMS group (Figure). There was a lesser vasoconstriction to Ach in the segments distal to ZESs than SESs (Figure). Conclusions: Vasoconstriction in response to Ach in the peristent region was less pronounced in ZES group than SES group at 6 months follow-up, which suggests that endothelial dysfunction associated with ZES can be restored more rapidly than those of SES.