Abstract 1146: Clinical Relevance of Endothelial Dysfunction after Sirolimus-Eluting Stent Implantation
BACKGROUND: SES could induce prolonged impaired endothelial function causing coronary artery vasoconstriction. The purpose of the present study was to investigate the incidence and clinical relevance of endothelial dysfunction after sirolimus-eluting stent (SES) implantation.
METHODS: From our prospective institutional database, 279 patients were solely treated with SES from June 2006 to July 2007. Among 279 patients, the patient without angiographic in-stent restenosis at the follow-up coronary angiography scheduled at 8 months were assessed the endothelial function if the patient has chest pain and/or positive results of exercise test at the time of angiography. Endothelial function was evaluated with infusion of incremental acetylcholine and nitrate. Vascular responses were quantitatively measured 10mm proximal and distal to SES. Endothelial dysfunction was defined as abnormal vasoconstriction of ≥ 3% mean vessel diameter changes.
RESULTS: Follow-up angiography was performed in 222 patients (78.9%). Angiographic restenosis was documented in 21 patients (7.5%). Endothelial function was evaluated in 25 patients (9.0%). Abnormal vasoconstriction was observed in all 25 patients at proximal or distal segments to SES. Additional medical therapy after the coronary angiography improved symptoms in 20 symptomatic patients thereafter.
CONCLUSION: Endothelial dysfunction was observed in patients after SES implantation, which may cause chest pain and/or abnormal exercise treadmill test in patients without angiographic in-stent restenosis.