Abstract 11022: Time-Dependent Changes of Local Coagulative Response up to Five Years After Sirolimus-Eluting Stent Implantation
Background: We have previously demonstrated increased local coagulative response six months after sirolimus-eluting stent (SES) implantation by measuring plasma prothrombin fragment F1+2 (frF1+2) levels. However, time-dependent changes of local hypercoagulability following SES implantation are not known.
Methods: Twenty-seven consecutive patients treated five years earlier with a coronary stenting for isolated left anterior descending (LAD) stenosis, with no evidence of restenosis, were studied. Twelve patients had been stented with bare-metal stent (BMS), and 15 with SES. We measured the levels of frF1+2 from the coronary sinus (CS) and sinus of Valsalva (V) 6 months (6M) and 5 years (5Y) after stent implantation. The transcardiac gradient (Δ) was defined as the CS levels minus V levels.
Results: There were no significant differences in coronary risk factors between the BMS and SES group at both stages. A larger percent diameter stenosis was observed at 5 years than at 6 months after stent implantation in the SES group (25.1±15.6 vs 7.1±16.5 %, p=0.02), whereas no significant changes were observed in the BMS group. The ΔfrF1+2 six months after stent implantation [ΔfrF1+2 (6M)] was significantly greater in the SES group than in the BMS group (21.2±13.4 vs 6.4±9.6 pmol/l, p<0.01). The ΔfrF1+2 five years after stent implantation [ΔfrF1+2 (5Y)] was not significant between the two groups (7.2±9.6 vs 5.1±8.8 pmol/l, p=n.s.). The time-dependent changes of ΔfrF1+2 [ΔfrF1+2 (5Y) minus ΔfrF1+2 (6M)] was significantly greater in the SES group than in the BMS group (−13.0±10.8 vs −0.9±8.9 pmol/l, p<0.01).
Conclusions: More time-dependent decrease of local coagulative response was observed after SES implantation as compared to BMS. In the SES group, sufficient neointimal regrowth in very late chronic phase might be associated with our findings.
- © 2010 by American Heart Association, Inc.