摘要
Aims: Endothetial dysfunction has been related both to progression of atheros clerotic disease and to future cardiovascular events. We assessed local epicardial endothelial function 6 months after sirolimus-eluting stent(SES) or bare metal stent(BS) implantation. Methods and results: In 12 patients(seven SES, five BS), endothelium-depen- dent vasomotion of a coronary segment 15 mm in length, starting 2 mm distal to the stent, was assessed with quantitative coronary angiography immediately after the procedure and at 6 months follow-up, after intracoronary infusion of acetylcholine. Intravascular ultrasound(IVUS) was performed and coronary flow reserve(CFR) assessed in all patients. At follow-up significant vasoconstriction was seen in SES(median 32% diameter reduction from baseline) but not in BS(median 2% reduction) patients after acetylcholine infusion(P=0.03 for SES vs. BS); endothelium-independent vasodilatation to nitrates did not differ significantly between groups(20% SES, 5% BS, P=0.14). IVUS revealed no late unhealed dissections and CFR was comparable between groups(SES 3.1 vs. BS 3.2, n.s.). Conclusion: SES implantation may have an adverse effect on local endothelium-dependent vasomotor responses compared with BS implantation at 6 months. Long-term clinical consequences of this observation are still unknown.
Aims： Endothetial dysfunction has been related both to progression of atherosclerotic disease and to future cardiovascular events. We assessed local epicardial endothelial function 6 months after sirolimus-eluting stent（SES） or bare metal stent（BS） implantation. Methods and results： In 12 patients（seven SES, five BS）, endothelium-dependent vasomotion of a coronary segment 15 mm in length, starting 2 mm distal to the stent, was assessed with quantitative coronary angiography immediately after the procedure and at 6 months follow-up, after intracoronary infusion of acetylcholine. Intravascular ultrasound （IVUS） was performed and coronary flow reserve（CFR） assessed in all patients. At follow-up significant vasoconstriction was seen in SES（median 32% diameter reduction from baseline） but not in BS（median 2% reduction） patients after acetylcholine infusion（P=0.03 for SES vs. BS）; endotheliurn-independent vasodilatation to nitrates did not differ significantly between groups（20% SES, 5% BS, P=0. 14） .
