Document Detail

Treatment of acute myocardial infarction with sirolimus-eluting stents results in chronic endothelial dysfunction in the infarct-related coronary artery.
MedLine Citation:
PMID:  20031747     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Sirolimus-eluting stent (SES) implantation aggravated endothelial vasomotor dysfunction in infarct-related coronary arteries. METHODS AND RESULTS: This study examined the effect of SES implantation on the duration of reperfusion-induced endothelial vasomotor dysfunction in infarct-related coronary arteries and on postinfarct left ventricular dysfunction in acute myocardial infarction (AMI). Patients with a first AMI due to occlusion of the left anterior descending coronary artery and successful reperfusion using SES (n=15) or bare metal stents (BMS; n=18) were examined. The vasomotor response of the left anterior descending coronary artery to acetylcholine and left ventriculography were examined 2 weeks and 6 months after AMI. At 6 months after AMI, the impairment of epicardial coronary artery dilation and coronary blood flow increase in response to acetylcholine was recovered from 2 weeks after AMI in BMS-treated patients, whereas the responses of SES-treated patients improved but remained impaired compared with BMS-treated patients (% increase in blood flow, 77+/-12% in SES versus 116+/-15% in BMS at 10 microg/min of acetylcholine, P<0.01). Left ventricular regional wall dysfunction in the left anterior descending coronary artery territory improved from 2 weeks to 6 months after AMI in BMS-treated patients but not in SES-treated patients (% improvement of average SD/chord, 6% in SES versus 19% in BMS, P<0.05), although left ventricular global ejection fraction was similar between the groups at any time points. CONCLUSIONS: SES implantation may delay recovery of reperfusion-induced endothelial vasomotor dysfunction in infarct-related coronary arteries and left ventricular regional dysfunction for at least 6 months after AMI.
Jyun-Ei Obata; Takamitsu Nakamura; Yoshinobu Kitta; Yasushi Kodama; Keita Sano; Ken-Ichi Kawabata; Yukio Saitoh; Daisuke Fujioka; Tsuyoshi Kobayashi; Toshiaki Yano; Yosuke Watanabe; Kazuhiro Watanabe; Kiyotaka Kugiyama
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-09-29
Journal Detail:
Title:  Circulation. Cardiovascular interventions     Volume:  2     ISSN:  1941-7632     ISO Abbreviation:  Circ Cardiovasc Interv     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-12-24     Completed Date:  2010-03-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101499602     Medline TA:  Circ Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  384-91     Citation Subset:  IM    
Department of Internal Medicine II, Faculty of Medicine, University of Yamanashi, Chuo City, Japan.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use
Coronary Vessels / physiopathology*
Drug-Eluting Stents*
Endothelium, Vascular / physiopathology*
Middle Aged
Myocardial Infarction / therapy*
Myocardial Reperfusion / adverse effects
Regional Blood Flow / physiology
Retrospective Studies
Sirolimus / therapeutic use*
Stroke Volume / physiology
Time Factors
Ventricular Dysfunction, Left / physiopathology
Reg. No./Substance:
0/Anti-Bacterial Agents; 53123-88-9/Sirolimus

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