Differential recovery of coronary endothelial dysfunction associated with zotarolimus- versus sirolimus-eluting stent

초록

Background: We compared the coronary endothelial dysfunction in patients with a Zotarolimus (ZES: EndeavorTM)- versus Sirolimus-eluting stent (SES: CypherTM) implantation at 6 months follow-up. Methods: In 40 patients (male 21, 54.7±9.5 yrs) treated with IVUS guided stenting to the mid segment of left anterior descending artery (15 ZES, 15 SES, 10 BMS: bare metal stent), endothelial function was prospectively estimated at pre- and post-intervention 6 months follow-up, by incremental acetylcholine (Ach1 :10, Ach2: 20, Ach3: 50, Ach4: 100 μg/min) and nitrate (200 ug/min) infusion into the left coronary ostium. The vascular response was quantitatively measured in the segment 5 mm proximal and distal to the 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 both ZES and SES group (ZES: <0.05, SES: p<0.01). There was a lesser vasoconstriction to Ach in ZES group than in SES group (Figure, p<0.05). The vasoconstriction to Ach was more prominent in the segment distal- than proximal to the stent in both ZES and SES group (p<0.001, Figure). Endothelium-independent vasodilatation to nitrates did not differ significantly between groups. Conclusion: 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.