In-stent coronary restenosis, but not the type of stent, is associated with impaired endothelial-dependent vasodilatation.
In-stent coronary restenosis, but not the type of stent, is associated with impaired endothelial-dependent vasodilatation.
Precise mechanisms leading to restenosis are not fully understood. The type of implanted stent and the intensity of atherogenic processes may affects the restenosis rate.To compare the long-term effects of the coronary stent implantation - paclitaxel-eluting stent (PES) or bare-metal stents (BMS) - on endothelial-dependent flow-mediated dilation (FMD), platelet-derived growth factor (PDGF) and asymmetric dimethylarginine (ADMA) serum levels and to assess the relationship between FMD, PDGF, ADMA and every-stage in-stent restenosis (eISR).The study population included 40 patients with coronary artery disease, who underwent elective percutaneous coronary intervention (PCI) of the left anterior descending artery (LAD) with stent implantation (PES - 21 patients; BMS - 19 patients). Follow-up examination was performed 12 months after PCI.There were no differences between the PES and the BMS patients regarding FMD (PES: 11.8+/-7.8%, BMS: 10.5+/-9.2%), PDGF (PES: 5540+/-2209 pg/ml, BMS: 4923+/-2924 pg/ml) and ADMA (PES: 0.474+/-0.04 micromol/l, BMS: 0.456+/-0.03 micromol/l) serum levels. The follow-up angiography was performed when clinically indicated in 25 patients: in 15 patients with PES and 10 patients with BMS implanted. The eISR was found in 12 subjects: in 7 (47%) with PES and in 5 (50%) with BMS (NS). In all patients with eISR, the FMD values were significantly lower (6.1+/-3.5%, p=0.003) compared to the patients without eISR (14.3+/-7.8%). FMD was the only independent risk factor for eISR (OR=0.631, 95% CI 0.412-0.942, p=0.0003). The cut-off point for FMD < or = 8.4% as a parameter predicting eISR was established (p=0.0001, sensitivity: 83.3%, specificity: 92.3%, PPV: 90.9%, NPV: 85.7%).The type of stent implanted into LAD does not affect the FMD, PDGF and ADMA serum levels assessed one-year after a PCI procedure. The occurrence of an early in-stent restenosis is associated with impaired FMD at the time of one-year follow-up.
Male, Time Factors, Coronary Stenosis, Angiotensin-Converting Enzyme Inhibitors, Middle Aged, Coronary Vessels, Coronary Restenosis, Vasodilation, Risk Factors, Humans, Female, Stents, Endothelium, Vascular, Poland, Angioplasty, Balloon, Coronary, Platelet Aggregation Inhibitors, Aged, Follow-Up Studies
Male, Time Factors, Coronary Stenosis, Angiotensin-Converting Enzyme Inhibitors, Middle Aged, Coronary Vessels, Coronary Restenosis, Vasodilation, Risk Factors, Humans, Female, Stents, Endothelium, Vascular, Poland, Angioplasty, Balloon, Coronary, Platelet Aggregation Inhibitors, Aged, Follow-Up Studies
13 Research products, page 1 of 2
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