Abstract 17882: Differential Responses of Local Coagulation after Implantation of Second-Generation Drug-Eluting Stent Compared with First-Generation Drug-Eluting Stents
Purpose: We have previously demonstrated local persistent hypercoagulation after sirolimus-eluting stent(SES) implantation by measuring plasma prothrombin fragment F1+2(frF1+2) levels. The aim of this study is to examine local coagulation response after second-generation drug-eluting stent(DES) [everolimus-eluting stent(EES) and zotarolimus-eluting stent(ZES)] implantation compared with first-generation DES [paclitaxel-eluting stent(PES) and SES] and bare metal stents(BMS).
Methods: Eighty-five patients who were treated eight months earlier with coronary stenting, with no evidence of restenosis, were studied(EES:12pts, ZES:15pts, PES:18pts, SES:20pts, and BMS:20pts). We measured plasma levels of frF1+2 sampled in coronary sinus(CS) and sinus of Valsalva(V). The transcardiac frF1+2 gradients(ΔfrF1+2) were defined as CS level minus V level.
Results: A larger percent diameter stenosis(%DS) was observed in the ZES and BMS groups than in the SES group(17.1±13.2, 25.1±15.6 vs 7.1±16.5 %, p<0.05, respectively). The ΔfrF1+2 was smaller in the ZES and EES groups, and larger in the PES groups than in the SES group(5.5±8.4, 3.3±11.7, 32.3±24.2 vs 23.4±21.1 pmol/l, p<0.05, respectively). The ΔfrF1+2 was smaller in the second-generation DES group than in the first-generation DES group(4.8±10.1 vs 27.3±23.8 pmol/l, p<0.05).
Conclusions: A decreased response of local coagulation after second-generation DES implantation were observed, as compared to first-generation DES implantation. These findings might be associated with lower strut thickness, unique characteristics of polymer, and lower cytotoxic effect of eluted drug in second-generation DES.
Author Disclosures: H. Yamazaki: None. T. Wakatsuki: None. K. Yamaguchi: None. K. Imada: None. K. Matsumoto: None. Y. Takagawa: None. E. Takagi: None. Y. Saijo: None. T. Hara: None. Y. Saito: None. M. Bando: None. A. Takashima: None. S. Bando: None. T. Matsuura: None. T. Ise: None. J. Hotchi: None. T. Tobiume: None. S. Yagi: None. T. Iwase: None. H. Yamada: None. T. Soeki: None. M. Sata: None.
- © 2014 by American Heart Association, Inc.