Document Detail


Impact of stenting and oral sirolimus on endothelium-dependent and independent coronary vasomotion.
MedLine Citation:
PMID:  22406990     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There is no consensus regarding the impact of stenting on long-term endothelial function. There have been reports of increased endothelial dysfunction with sirolimus-eluting stents as compared to bare metal stenting (BMS).
OBJECTIVE: This study aims to assess the impact of BMS and the effect of oral sirolimus on endothelial function.
METHODS: Forty-five patients were randomized into three groups: BMS + high-dose oral sirolimus (initial dose of 15 mg, followed by 6 mg/day for four weeks); BMS + low-dose sirolimus (6 mg followed by 2 mg daily for four weeks); and BMS without sirolimus. Changes in vasoconstriction or vasodilation in a 15 mm segment starting at the distal stent end in response to acetylcholine and nitroglycerin were assessed by quantitative angiography.
RESULTS: The groups had similar angiographic characteristics. The percent variation in diameter in response to acetylcholine was similar in all groups at the two time points (p = 0.469). Four hours after stenting, the target segment presented an endothelial dysfunction that was maintained after eight months in all groups. In all groups, endothelium-independent vasomotion in response to nitroglycerin was similar at four hours and eight months, with increased target segment diameter after nitroglycerin infusion (p = 0.001).
CONCLUSION: The endothelial dysfunction was similarly present at the 15 mm segment distal to the treated segment, at 4 hours and 8 months after stenting. Sirolimus administered orally during 4 weeks to prevent restenosis did not affect the status of endothelium-dependent and independent vasomotion.
Authors:
Rósley Weber Alvarenga Fernandes; João Miguel Dantas; Dinaldo Cavalcanti Oliveira; Hiram Grando Bezerra; Fabio Sandoli Brito; Valter C Lima
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-03-08
Journal Detail:
Title:  Arquivos brasileiros de cardiologia     Volume:  98     ISSN:  1678-4170     ISO Abbreviation:  Arq. Bras. Cardiol.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-06-27     Completed Date:  2013-03-22     Revised Date:  2013-03-29    
Medline Journal Info:
Nlm Unique ID:  0421031     Medline TA:  Arq Bras Cardiol     Country:  Brazil    
Other Details:
Languages:  eng; por     Pagination:  290-8     Citation Subset:  IM    
Affiliation:
Hospital São Paulo - SPDM - Universidade Federal de São Paulo, São Paulo, SP, Brazil. rosley@uol.com.br
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MeSH Terms
Descriptor/Qualifier:
Acetylcholine / pharmacology,  therapeutic use
Administration, Oral
Adult
Analysis of Variance
Coronary Vessels / drug effects*,  physiopathology
Endothelium, Vascular / drug effects*,  physiopathology
Female
Humans
Immunosuppressive Agents / administration & dosage,  pharmacology*
Male
Middle Aged
Nitroglycerin / pharmacology,  therapeutic use
Sirolimus / administration & dosage,  pharmacology*
Stents / adverse effects*
Time Factors
Vasoconstriction / drug effects,  physiology
Vasodilation / drug effects,  physiology
Vasodilator Agents / pharmacology,  therapeutic use
Vasomotor System / drug effects*,  physiopathology
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Vasodilator Agents; 51-84-3/Acetylcholine; 53123-88-9/Sirolimus; 55-63-0/Nitroglycerin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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