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  • Ovid Technologies (Wolters Kluwer Health)  (11)
  • Sano, Keita  (11)
  • 1
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    Abstract 5068: A Prospective Randomized Comparative Trial of Bezafibrate and Pravastatin in Patients with Coronary Artery Disease and High Remnant Lipoprotein Levels
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Circulation Vol. 118, No. suppl_18 ( 2008-10-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 118, No. suppl_18 ( 2008-10-28)
    Abstract: Remnant lipoproteinemia is a strong risk factor for atherosclerotic cardiovascular diseases (CVD). However, it remains unclear whether the lowering of remnant lipoprotein levels can prevent CVD events, and it is uncertain which lipid-lowering drug is most effective in reducing remnant lipoprotein levels or CVD events. Thus, this study examined if lowering of remnant lipoprotein levels can reduce CVD risk and which of two common lipid-lowering drugs (fibrate or statin) is more effective. The serum levels of remnant lipoproteins were measured by an immunoseparation method (remnant-like lipoprotein particles cholesterol; RLP-C). This multi-center study recruited 202 patients with chronic coronary artery disease (CAD), high RLP-C levels (≥ 5.0 mg/dL), and mild hypercholesterolemia (≥ 180 and 〈 260 mg/dL). They were randomly assigned to receive bezafibrate (Beza, 200 ~ 400 mg/day, n = 101) or pravastatin (Prava, 10 ~ 20 mg/day, n = 101), and were prospectively followed-up for 1 year or until the occurrence of a CVD event: cardiac death, nonfatal myocardial infarction, unstable angina pectoris requiring unplanned revascularization, or ischemic stroke. The 2 groups had similar baseline levels of RLP-C (average in total patients, 9.8 ± 0.4 mg/dL), LDL-C (126 ± 6.0 mg/dL), HDL-C (43 ± 1.2 mg/dL), and triglycerides (212 ± 9.7 mg/dL). RLP-C levels at 1 year of treatment were reduced in Beza more than Prava (by - 30% and - 19% from baseline, respectively), whereas reduction of LDL-C levels was less in Beza than Prava (by - 7% and -15%). During follow up, CVD events occurred in 3 patients treated with Beza and in 11 patients with Prava (p = 0.03 by chi-square test) (cardiac death in 0 and 1, unstable angina in 2 and 10, and stroke in 1 and 0, respectively). In a multivariate Cox hazards analysis, reduction of 1-SD (38%) of percent change in RLP-C levels decreased risk of future CVD events by 36% independently of change in LDL-C and HDL-C levels (HR 0.64, 95% CI 0.46 – 0.90, p = 0.01). Bezafibrate therapy decreased RLP-C levels and CVD events to a greater extent than pravastatin in CAD patients with high RLP-C levels and mild hypercholesterolemia. Reduction of remnant lipoprotein levels may improve outcomes in CAD patients with high remnant lipoprotein levels.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.118.suppl_18.S_1139
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
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  • 2
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    Abstract 5070: Progression of Urine Albumin Excretion Despite of Optimized Therapies to Reduce Atherosclerotic Risk Factors has an Adverse Outcome in Patients with Coronary Artery Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Circulation Vol. 118, No. suppl_18 ( 2008-10-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 118, No. suppl_18 ( 2008-10-28)
    Abstract: Although microalbuminuria is considered a strong risk factor of future cardiovascular disease (CVD), it remains unclear whether changes in urine albumin excretion (UAE) in response to a reduction of coronary risk factors may provide prognostic information in patients with coronary artery disease (CAD). Thus, this study assessed the hypothesis that changes in UAE in response to optimized therapy for reduction of CAD risk may predict future CVD events in patients with CAD. This study enrolled of 213 patients with newly diagnosed CAD who had microalbuminuria (30 mg/day ≤ UAE 〈 300 mg/day) at entry. Patients with late-stage chronic kidney disease (GFR 〈 60 ml/min/1.73 m 2 ) at entry were excluded. All patients had individualized, optimized therapies including medications and recommended life style changes to reduce risk factors for CAD according to AHA guidelines. All patients had a repeated test of UAE at 6 months (2 nd test) after the 1 st UAE test. Thereafter, all patients were prospectively followed up for 3 years or until the occurrence of 1 of the following events: CVD death, nonfatal myocardial infarction, unstable angina pectoris requiring revascularization, or ischemic stroke. Progression of UAE at the 2 nd test was defined as 〉 50% increase from the UAE at the 1 st test. UAE at 2 nd test was progressed in 62 (29%) patients, while it was not progressed in the remaining 151 (71%) patients. UAE at entry was comparable between patients with and without progression of UAE (52 ± 6.2 vs.61 ± 4.7 mg/day, respectively, p = ns). During follow-up period, events occurred in 15 (24%) of the 62 patients with progression of UAE and in 16 (10%) of the 151 patients without progression of UAE (p 〈 0.01 by chi-square test). Using a multivariate Cox hazards analysis, progression of UAE was a predictor of future CVD events that was independent of UAE at 1 st test, use of medications, age, and traditional CAD risk factors (HR 2.5, 95%CI 1.2 – 4.8, p = 0.01). Progression of urine albumin excretion despite individualized and optimized therapies to reduce CAD risk factors represents an adverse outcome in CAD patients. Periodic measurement of urine albumin excretion may be useful for risk stratification in CAD.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.118.suppl_18.S_1139-b
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
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  • 3
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    Abstract 1548: High Plasma Levels of Stromal Cell-Derived Factir-1 alpha Predict Future Cardiovascular Events in Patients with Previous Myocardial Infarction
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Circulation Vol. 116, No. suppl_16 ( 2007-10-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 116, No. suppl_16 ( 2007-10-16)
    Abstract: Stromal cell-derived factor-1 alpha (SDF-1α) is expressed in ischemic myocardium and atheromatous plaques and plays a key role in the repair of injured myocardium. We examined whether SDF-1α in circulating plasma may play a role in pathophysiology of myocardial infarction (MI). Methods and Results: SDF-1α levels in plasma from a peripheral vein (PV) were measured using ELISA in 206 consecutive patients with previous MI and in 50 age- and sex-matched controls. The levels were also measured in plasma from the aorta (AO) and the anterior interventricular vein (AIV) in a subgroup of 82 patients with anterior MI. After baseline measurements, all patients with previous MI were prospectively followed for ≤ 60 months or until occurrence of a clinical cardiovascular event: cardiac death, nonfatal myocardial infarction, refractory angina pectoris requiring coronary revascularization, or hospitalization with congestive heart failure. PV levels of SDF-1α were higher in patients with MI than controls (2750 ± 79 vs. 2351 ± 72 pg/mL, p 〈 0.01). In addition, PV levels were significantly higher in MI patients with (n = 42) than without an event (n = 164) (2909 ± 108 vs. 2645 ± 41 pg/mL, p 〈 0.01). In multivariate Cox hazard analysis, a higher level of SDF-1α ( 〉 3040 pg/mL, defined by ROC analysis) was a predictor of the events independently of traditional coronary risk factors (hazard ratio 2.2, 95% CI 1.1 – 4.1, p 〈 0.01). Moreover, there was a significant step-up in SDF-1α levels in the AIV compared with the AO in patients with anterior MI (2868 ± 49 vs. 2681 ± 60 pg/mL, p 〈 0.05). The AIV - AO difference in SDF-1α levels, reflecting release from ischemic myocardium, correlated positively with PV levels of SDF-1α (r = 0.23, p 〈 0.05). Both the AIV - AO difference in SDF-1α levels and the PV levels had a significant correlation positively with PV levels of brain natriuretic peptide and inversely with left ventricular (LV) ejection fraction. Conclusions: Higher SDF-1α levels in the peripheral circulation independently predict cardiovascular events in patients with prior MI. SDF-1α is released from ischemic myocardium in proportion to the severity of LV dysfunction via a compensatory mechanism, which may partly contribute to increased circulating levels of SDF-1α in MI survivors.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.116.suppl_16.II_321-b
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
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  • 4
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    Abstract 3118: Combined Assessment of Intima-Media Thickness and Echolucency of an Atherosclerotic Plaque in Carotid Artery has an Additive Value on Prediction of Future Coronary Events in Patients with Coronary Artery Disease and Carotid Atherosclerosis
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Circulation Vol. 118, No. suppl_18 ( 2008-10-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 118, No. suppl_18 ( 2008-10-28)
    Abstract: Single ultrasound assessment of either intima-media thickness (IMT) or plaque echolucency of carotid artery is considered a surrogate for systemic atherosclerotic burden and provides prognostic information for coronary events. The assessment of IMT and plaque echolucency of carotid artery has the advantage of obtaining structural and compositional information on atherosclerotic plaques in a single session. This study examined the hypothesis that the combined ultrasound assessment of IMT and echolucency in a carotid artery may have an additive effect on the prediction of coronary events in patients with coronary artery disease (CAD). Ultrasound assessment of carotid IMT and plaque echolucency with integrated backscatter (IBS) analysis (intima-media IBS value minus adventitia IBS) was performed in 411 patients with CAD and carotid plaques (IMT ≥ 1.1 mm). The plaque with the greatest axial thickness in carotid arteries was the target for measurement of maximum IMT (plaque-IMTmax) and echolucency (lower IBS reflects echolucent plaque). All patients were prospectively followed up for 70 months or until the occurrence of one of the following coronary events: cardiac death, nonfatal myocardial infarction, or unstable angina pectoris requiring revascularization. During follow-up, 49 coronary events occurred (cardiac death in 2, myocardial infarction in 10, unstable angina in 37). In a multivariate Cox hazards analysis, plaque-IMTmax and plaque echolucency (lower IBS value) were significant predictors of coronary events (HR; 1.82 and 0.85, 95% CI 1.2 – 2.9 and 0.80 – 0.91, respectively, both p 〈 0.01) independently of age, LDL-C levels, and diabetes. When outcomes were stratified according to plaque-IMTmax and plaque echolucency in combination or alone, the combination of plaque-IMTmax and plaque echolucency was the strongest predictor of events, followed by plaque echolucency and plaque-IMTmax, on the basis of the c -statistic (area under the ROC curve; 0.80, 0.73, and 0.71, respectively). Combined ultrasound assessment of IMT and echolucency of carotid plaque had an additive value on the prediction of coronary events, and these simultaneous ultrasound measurements may be useful for risk stratification in CAD.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.118.suppl_18.S_1095-b
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
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  • 5
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    Abstract 2168: Sirolimus-eluting Stent Implantation at Proximal Site Inhibits In-stent Restenosis in Bare Metal Stent Placed at Distal Site of de novo Lesion in Same Coronary Artery
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Circulation Vol. 116, No. suppl_16 ( 2007-10-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 116, No. suppl_16 ( 2007-10-16)
    Abstract: Drug-eluting stent (DES) suppresses peri-stent distal edge stenosis via a local diffusion of the drug. Diffusion of sirolimus into coronary blood flowing may cause an accumulation of this drug in coronary bed beyond the distal edge of sirolimus-eluting stent (SES). Thus, this study examined whether SES implantation may exert anti-proliferative action on bare metal stent (BMS) placed distally in the same coronary artery. Methods and Results: We prospectively examined 114 consecutive patients with stable coronary artery disease who met the following inclusion criteria: elective, successful percutaneous coronary intervention for a long de novo lesion or two adjacent de novo lesions treated with more than two stents in the same coronary artery, implantation of BMS (2.25 mm in size, 12 ~ 18 mm in length) in the distal site because no DES was available due to small vessel size, quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) at stent placement and at 6 months or during the 6 months follow up after the stenting. At the proximal site adjacent to the distal BMS, SES was implanted without gap in 57 patients (SES-BMS), and BMS in the remaining 57 patients (BMS-BMS). Patients with in-stent restenosis (ISR, defined as 〉 50% diameter stenosis), developed at the proximal stent during the 6 months follow up, were excluded from the further analysis (all of them were 14 patients with BMS-BMS). Clinical, lesion, and procedural variables at stenting were comparable between SES-BMS (n = 57) and BMS-BMS (n = 43) groups. The QCA of the distal BMS showed less late luminal loss (0.49 ± 0.06 vs. 0.91 ± 0.08 mm, p 〈 0.01) and a lower ISR rate (13% vs. 36%, p 〈 0.01) in the SES-BMS group than the BMS-BMS group. The SES-BMS group also had less neointimal hyperplasia volume (25.1 ± 2.2 vs. 37.1 ± 2.5 mm 3 , p 〈 0.01) than the BMS-BMS group in the IVUS which examined a 10-mm length of the distal BMS from the distal edge of the proximal stent. Target lesion revascularization (TLR) of the distal BMS was less frequent in the SES-BMS group compared with the BMS-BMS group (9% vs. 19%, p 〈 0.01). Conclusions: SES implantation inhibits ISR and TLR in BMS at distal site of de novo lesion in same coronary artery. These findings may have an implication for stent strategy in long lesions.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.116.suppl_16.II_470-c
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
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  • 6
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    Abstract 385: Endothelial Vasomotor Dysfunction in Brachial Artery Predicts Early Renal Dysfunction in Patients with Coronary Artery Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Circulation Vol. 116, No. suppl_16 ( 2007-10-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 116, No. suppl_16 ( 2007-10-16)
    Abstract: There is an intimate relation between coronary artery disease (CAD) and chronic kidney disease. Endothelial function in renal vasculature plays an important role in regulation of renal hemodynamics in normal and pathological states. Endothelial dysfunction is a systemic disorder, and there may be possible relation of endothelial function between brachial artery and renal vasculature. We examined whether endothelial vasomotor dysfunction in brachial artery may predict early renal dysfunction in patients with CAD. Methods and Results: Flow-mediated endothelium-dependent dilation (FMD, % increase in diameter from baseline) in brachial artery was measured by ultrasound in 558 consecutive patients with CAD. Patients with advanced renal failure (glomerular filtration rate [GFR] 〈 50 mL/min/1.73 m 2 ) were not included. A subgroup of 402 patients with normal renal function at the enrollment (normo-albuminuria [ 〈 30 mg/day] and normal serum creatinine levels [ 〈 1.0 mg/dL]) were prospectively followed up for 1 year. The end point was the occurrence of either microalbuminuria (≥ 30 mg/day) or serum creatinine levels 〉 1.5 mg/dL. At the enrollment, patients with impaired FMD (≤ 4.4%, 50 th percentile of the distribution in all study patients) had higher levels of urine albumin excretion (24 ± 2 vs. 17 ± 1 mg/day, p 〈 0.05) and serum creatinine (0.8 ± 0.1 vs. 0.5 ± 0.1 mg/dL, p 〈 0.05), and lower GFR (72 ± 3 vs. 80 ± 2 mL/min/1.73 m 2 , p 〈 0.05) than patients with preserved FMD ( 〉 4.4%). Over 1 year follow up, 30 (17%) patients with impaired FMD had an end point (12 patients, increase in serum creatinine levels; 18, microalbuminuria), while 15 (6.7%) patients with preserved FMD had an end point (6, increase in serum creatinine levels; 9, microalbuminuria) (p 〈 0.01). Using multivariate logistic analysis, impaired FMD was the most strongest predictor of occurrence of either increase in serum creatinine levels or microalbuminuria during 1 year follow up (OR; 2.8, 95% CI; 1.5 – 5.5, p 〈 0.01) among covariates including hypertension, diabetes, age. Conclusion: Endothelial vasomotor dysfunction in brachial artery is an independent predictor of development of early renal dysfunction in patients with CAD. Measurement of FMD is useful for stratification of risk for future renal dysfunction.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.116.suppl_16.II_61-a
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
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  • 7
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    Treatment of Acute Myocardial Infarction With Sirolimus-Eluting Stents Results in Chronic Endothelial Dysfunction in the Infarct-Related Coronary Artery
    Ovid Technologies (Wolters Kluwer Health) ; 2009
    In:  Circulation: Cardiovascular Interventions Vol. 2, No. 5 ( 2009-10), p. 384-391
    Details
    In: Circulation: Cardiovascular Interventions, Ovid Technologies (Wolters Kluwer Health), Vol. 2, No. 5 ( 2009-10), p. 384-391
    Abstract: 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 μg/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.
    Type of Medium: Online Resource
    ISSN: 1941-7640 , 1941-7632
    URL: Article
    DOI: 10.1161/CIRCINTERVENTIONS.108.821371
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2009
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  • 8
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    Abstract 829: High Plasma Levels of Stromal Cell-Derived Factor-1 Alpha Predict a Worse Prognosis in Patients with Chronic Heart Failure
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Circulation Vol. 118, No. suppl_18 ( 2008-10-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 118, No. suppl_18 ( 2008-10-28)
    Abstract: Stromal cell-derived factor-1 alpha (SDF-1α) is expressed in injured myocardium and plays a key role in the repair of the injured myocardium. This study examined whether SDF-1α in the circulation may have a prognostic information in patients with heart failure (HF). SDF-1α levels in plasma from a peripheral vein (PV) were measured using ELISA in 297 patients with chronic HF defined by the Framingham criteria, who had LV functional abnormalities (102 patients in NYHA class II, 65 in NYHA III, 32 in NYHA IV), and in 50 age- and sex-matched controls. The levels were also measured in plasma from the aorta (AO) and the coronary sinus (CS) in a subgroup of 82 HF patients. Then, all patients with HF were prospectively followed for 60 months or until occurrence of cardiac death or hospitalization with worsening HF. PV levels of SDF-1α were higher in HF patients than controls (2661 ± 67 vs. 2320 ± 55 pg/mL, p 〈 0.01), and patients with higher NYHA class had higher SDF-1α levels (ρ = 0.41, p 〈 0.0001). The PV levels of SDF-1α were similar between patients with ischemic HF (n = 204) and non-ischemic HF (n = 93). During follow-up, 19 cardiac death and 69 hospitalization occurred. The PV levels of SDF-1α were higher in patients with an event than those without an event (2820 ± 78 vs. 2490 ± 38 pg/mL, p 〈 0.01). In a multivariate Cox hazards analysis, a higher level of SDF-1α ( 〉 3040 pg/mL, defined by ROC analysis) was a predictor of events that was independent of age, LVEF, use of medications, and BNP levels (HR 2.1, 95% CI 1.2–4.2, p 〈 0.01). Moreover, the CS - AO difference in SDF-1α levels, reflecting release from the heart, was higher in patients with (n = 21) than without an event (n = 67) (80 ± 46 vs. −32 ± 33 pg/mL, p 〈 0.01). The CS - AO difference in SDF-1α levels was positively correlated with the PV levels (r = 0.22, p 〈 0.05). Both the CS - AO difference in SDF-1α levels and the PV levels had a significant positive correlation with PV levels of BNP and an inverse correlation with LVEF. Higher SDF-1α levels in the peripheral circulation independently predict a worse outcome in patients with chronic HF. SDF-1α is released from the heart in proportion to the severity of LV dysfunction via a compensatory mechanism and may partly contribute to increased circulating levels of SDF-1α in chronic HF.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.118.suppl_18.S_620-a
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
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  • 9
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    Rapid Stabilization of Vulnerable Carotid Plaque Within 1 Month of Pitavastatin Treatment in Patients With Acute Coronary Syndrome
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Journal of Cardiovascular Pharmacology Vol. 51, No. 4 ( 2008-04), p. 365-371
    Details
    In: Journal of Cardiovascular Pharmacology, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. 4 ( 2008-04), p. 365-371
    Type of Medium: Online Resource
    ISSN: 0160-2446
    URL: Article
    DOI: 10.1097/FJC.0b013e318165dcad
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
    detail.hit.zdb_id: 2049700-3
    SSG: 15,3
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  • 10
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    Abstract 2567: Late Catch-Up Recovery from Endothelial Vasomotor Dysfunction in Infarct-Related Coronary Artery Treated with Sirolimus-Eluting Stent in Patients with Acute Myocardial Infarction
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Circulation Vol. 118, No. suppl_18 ( 2008-10-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 118, No. suppl_18 ( 2008-10-28)
    Abstract: Myocardial ischemia-reperfusion causes endothelial injury in the infarct-related coronary artery. We have previously shown that sirolimus-eluting stent (SES) implantation can aggravate endothelium-dependent vasomotor dysfunction in infarct-related coronary arteries. This study examined effects of SES implantation on duration of reperfusion-induced endothelial dysfunction in infarct-related coronary arteries. This study enrolled 44 patients with a first acute myocardial infarction (AMI) due to occlusion of the left anterior descending coronary artery (LAD) and successful reperfusion therapy using SESs (n = 22) or bare metal stents (BMS, n = 22). Vasomotor function of LAD in response to acetylcholine (ACh) was repeated 2 weeks, 6 months, and 9 months after AMI. Patients with either residual stenosis or in-stent restenosis in LAD were not included in this study. The vasomotor function was also assessed in 20 control subjects for comparison with that in AMI patients. The SES and BMS groups were similar in terms of AMI-related variables including peak CK levels and 2 week LVEF. At 2 weeks after AMI, SES-treated LAD had greater impairment of epicardial dilation and less blood flow increase in response to ACh than BMS-treated LAD (diameter response; 12% vs. 34% of controls, blood flow response; 23% vs. 76% of controls, at 10 μg/min of ACh, respectively). In BMS-treated LAD, the responses of epicardial diameter and blood flow to ACh had recovered to levels similar to those of controls at 6 months (diameter response; 94% of controls, blood flow response; 92% of controls), and the responses showed no further improvement from 6 to 9 months. In SES-treated LAD, the responses were improved but remained lowered compared with BMS-treated LAD at 6 months (diameter response; 58% of controls, blood flow response; 74% of controls). However, the responses in SES-treated LAD at 9 months showed further improvement to levels near to those of BMS-treated LAD or controls (diameter response; 79% of controls, blood flow response; 88% of controls). Although incomplete, the adverse effects of SES on endothelium-dependent vasomotor function in infarct-related coronary arteries were restored through late catch-up recovery after stent implantation.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.118.suppl_18.S_748-a
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
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