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Michalis Hamilos - One of the best experts on this subject based on the ideXlab platform.
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Coronary Vasomotion one year after drug eluting stent implantation comparison of everolimus eluting and paclitaxel eluting Coronary stents
Journal of Cardiovascular Translational Research, 2014Co-Authors: Michalis Hamilos, Flavio Ribichini, Miodrag Ostojic, Valeria Ferrero, Dejan Orlic, Corrado Vassanelli, Nevena Karanovic, Giovanna Sarno, Thomas Cuisset, Panos E VardasAbstract:First-generation drug-eluting stents (DES) have been associated with impaired localized Coronary Vasomotion and delayed endothelialization. We aimed to compare Coronary Vasomotion after implantation of a newer-generation everolimus-eluting stent (EES), with a first-generation paclitaxel-eluting stent (PES). Coronary Vasomotion was studied in 19 patients with EES and 13 with PES. Vasomotor response was measured proximally and distally to the stent and in a remote vessel (reference segment). Quantitative Coronary angiography was performed offline. Endothelium independent Vasomotion did not differ significantly between the two groups. EES showed significant vasodilatation while PES showed vasoconstriction at both proximal (+4.5 ± 3.6 vs −4.2 ± 6.9, p < 0.001) and distal (+4.6 ± 7.9 vs −4.8 ± 9.3, p = 0.003) segments. The reference segment did not show any significant difference in vasodilatation between the two groups (+9.8 ± 6.4 vs +7.2 ± 5.2, p = 0.17). Endothelium-dependent Vasomotion at adjacent stent segments is relatively preserved after EES implantation while vasoconstriction was observed after PES implantation.
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Coronary Vasomotion one year after drug-eluting stent implantation: comparison of everolimus-eluting and paclitaxel-eluting Coronary stents.
'Springer Science and Business Media LLC', 2014Co-Authors: Michalis Hamilos, Valeria Ferrero, Dejan Orlic, Nevena Karanovic, Giovanna Sarno, Thomas Cuisset, Ribichini, Flavio Luciano, C. M. Ostojic, Vassanelli Corrado, E. P. VardasAbstract:First-generation drug-eluting stents (DES) have been associated with impaired localized Coronary Vasomotion and delayed endothelialization. We aimed to compare Coronary Vasomotion after implantation of a newer-generation everolimus-eluting stent (EES), with a first-generation paclitaxel-eluting stent (PES). Coronary Vasomotion was studied in 19 patients with EES and 13 with PES. Vasomotor response was measured proximally and distally to the stent and in a remote vessel (reference segment). Quantitative Coronary angiography was performed offline. Endothelium independent Vasomotion did not differ significantly between the two groups. EES showed significant vasodilatation while PES showed vasoconstriction at both proximal (+4.5\u2009\ub1\u20093.6 vs -4.2\u2009\ub1\u20096.9, p\u2009
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interference of drug eluting stents with endothelium dependent Coronary Vasomotion evidence for device specific responses
Circulation-cardiovascular Interventions, 2008Co-Authors: Michalis Hamilos, Miodrag Ostojic, Giovanna Sarno, Thomas Cuisset, Emanuele Barbato, Jaydeep Sarma, Narbeh Melikian, Argyrios Ntalianis, Olivier Muller, Branco BeleslinAbstract:Background— There is evidence that endothelial coverage of drug-eluting stents might be delayed or absent, a risk factor for late thrombotic events. We studied the effects of different drug-polymer-device iterations on endothelium-dependent Coronary Vasomotion. Systemic markers of endothelial inflammation were correlated with Coronary vasomotor changes. Methods and Results— Patients with paclitaxel-eluting stents (n=11), sirolimus-eluting stents (n=21), biolimus A9-eluting stents (n=28), zotarolimus-eluting stents (n=10), and bare-metal stents (n=13) were studied 10, 9, 9, 9, and 12 months after implantation, respectively. Endothelium-dependent Coronary Vasomotion was tested proximally and distally to the stent and at a reference vessel segment during atrial pacing at increasing heart rates by quantitative Coronary angiography. Indexes of platelet-monocyte binding and other biomarkers were studied in a subgroup of 19 patients. The baseline characteristics and hemodynamics of the patients in the different stent groups were comparable. Significant differences were observed across the 5 stent groups, concerning the Vasomotion of segments proximal ( P =0.006) and distal ( P =0.003) to the stent. Normal Vasomotion (vasodilatation) was maintained in the biolimus A9-eluting stent, zotarolimus-eluting stent, and bare-metal stent groups, whereas vasoconstriction was observed in the sirolimus-eluting stent and paclitaxel-eluting stent groups. Platelet-monocyte binding in whole blood showed a significant inverse correlation with Vasomotion in reference but not in segments adjacent to the stent ( r =−0.57; P =0.01). Conclusions— Paclitaxel-eluting stents and sirolimus-eluting stents seem to cause endothelial dysfunction of the implanted vessel, whereas biolimus A9-eluting stents and zotarolimus-eluting stents behave more closely to bare-metal stents, with preserved endothelial vasomotor response. Coronary vasoconstriction was not associated with detectable systemic endothelial activation. Received June 13, 2008; accepted October 27, 2008.
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differential effects of drug eluting stents on local endothelium dependent Coronary Vasomotion
Journal of the American College of Cardiology, 2008Co-Authors: Michalis Hamilos, Miodrag Ostojic, Dejan Orlic, Branco Beleslin, Dragan Sagic, Ljubco Mangovski, Sinisa Stojkovic, Milan Nedeljkovic, Bratislav Milosavljevic, Dragan TopicAbstract:Objectives The aim of our study was to compare Coronary Vasomotion after implantation of a second-generation biolimus A9-eluting stent (BES) and of a sirolimus-eluting stent (SES). Background Drug-eluting stents (DES) have been associated with impaired local Coronary Vasomotion, delayed endothelialization, and increased late thrombotic risk. New DES with different drugs, pharmacokinetics, and polymers have been developed. Methods Nineteen patients with a BES and 15 patients with a SES were studied 9 months after stent implantation. Endothelium-dependent and -independent Coronary Vasomotion were tested proximally and distally to the stent as well as at a reference segment during right atrial pacing at increasing heart rates. Quantitative Coronary angiographic measurements were performed offline. Results Of the patients with BES, 2 showed vasoconstriction with increased heart rate and 17 showed vasodilatation. Of the patients with a SES, 9 showed vasoconstriction while 6 showed vasodilatation. The SES showed significant vasoconstriction at both the proximal (−2.3 ± 10% vs. 7.9 ± 10%) and the distal (−5.4 ± 9% vs. 6.1 ± 8%) segments to the stent compared with the BES (p = 0.003 for proximal, p Conclusions Unlike the case with the SES, endothelium-dependent Vasomotion at adjacent stent segments seems to be preserved after BES implantation. This result may be explained by the different drug release kinetics, DES design, or characteristics of polymer used in the stent system.
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differential effects of drug eluting stents on local endothelium dependent Coronary Vasomotion commentary
Journal of the American College of Cardiology, 2008Co-Authors: Michalis Hamilos, Miodrag Ostojic, Dejan Orlic, Branco Beleslin, Dragan Sagic, Ljubco Mangovski, Sinisa Stojkovic, Milan Nedeljkovic, Bratislav Milosavljevic, Dragan TopicAbstract:Objectives The aim of our study was to compare Coronary Vasomotion after implantation of a second-generation biolimus A9-eluting stent (BES) and of a sirolimus-eluting stent (SES). Background Drug-eluting stents (DES) have been associated with impaired local Coronary Vasomotion, delayed endothelialization, and increased late thrombotic risk. New DES with different drugs, pharmacokinetics, and polymers have been developed. Methods Nineteen patients with a BES and 15 patients with a SES were studied 9 months after stent implantation. Endothelium-dependent and -independent Coronary Vasomotion were tested proximally and distally to the stent as well as at a reference segment during right atrial pacing at increasing heart rates. Quantitative Coronary angiographic measurements were performed offline. Results Of the patients with BES, 2 showed vasoconstriction with increased heart rate and 17 showed vasodilatation. Of the patients with a SES, 9 showed vasoconstriction while 6 showed vasodilatation. The SES showed significant vasoconstriction at both the proximal (-2.3 ± 10% vs. 7.9 ± 10%) and the distal (-5.4 ± 9% vs. 6.1 ± 8%) segments to the stent compared with the BES (p = 0.003 for proximal, p < 0.001 for distal segment). Endothelium-independent Vasomotion after intraCoronary nitrates did not differ significantly between the 2 groups (p = NS for proximal and distal segment). Conclusions Unlike the case with the SES, endothelium-dependent Vasomotion at adjacent stent segments seems to be preserved after BES implantation. This result may be explained by the different drug release kinetics, DES design, or characteristics of polymer used in the stent system.
Miodrag Ostojic - One of the best experts on this subject based on the ideXlab platform.
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Coronary Vasomotion one year after drug eluting stent implantation comparison of everolimus eluting and paclitaxel eluting Coronary stents
Journal of Cardiovascular Translational Research, 2014Co-Authors: Michalis Hamilos, Flavio Ribichini, Miodrag Ostojic, Valeria Ferrero, Dejan Orlic, Corrado Vassanelli, Nevena Karanovic, Giovanna Sarno, Thomas Cuisset, Panos E VardasAbstract:First-generation drug-eluting stents (DES) have been associated with impaired localized Coronary Vasomotion and delayed endothelialization. We aimed to compare Coronary Vasomotion after implantation of a newer-generation everolimus-eluting stent (EES), with a first-generation paclitaxel-eluting stent (PES). Coronary Vasomotion was studied in 19 patients with EES and 13 with PES. Vasomotor response was measured proximally and distally to the stent and in a remote vessel (reference segment). Quantitative Coronary angiography was performed offline. Endothelium independent Vasomotion did not differ significantly between the two groups. EES showed significant vasodilatation while PES showed vasoconstriction at both proximal (+4.5 ± 3.6 vs −4.2 ± 6.9, p < 0.001) and distal (+4.6 ± 7.9 vs −4.8 ± 9.3, p = 0.003) segments. The reference segment did not show any significant difference in vasodilatation between the two groups (+9.8 ± 6.4 vs +7.2 ± 5.2, p = 0.17). Endothelium-dependent Vasomotion at adjacent stent segments is relatively preserved after EES implantation while vasoconstriction was observed after PES implantation.
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interference of drug eluting stents with endothelium dependent Coronary Vasomotion evidence for device specific responses
Circulation-cardiovascular Interventions, 2008Co-Authors: Michalis Hamilos, Miodrag Ostojic, Giovanna Sarno, Thomas Cuisset, Emanuele Barbato, Jaydeep Sarma, Narbeh Melikian, Argyrios Ntalianis, Olivier Muller, Branco BeleslinAbstract:Background— There is evidence that endothelial coverage of drug-eluting stents might be delayed or absent, a risk factor for late thrombotic events. We studied the effects of different drug-polymer-device iterations on endothelium-dependent Coronary Vasomotion. Systemic markers of endothelial inflammation were correlated with Coronary vasomotor changes. Methods and Results— Patients with paclitaxel-eluting stents (n=11), sirolimus-eluting stents (n=21), biolimus A9-eluting stents (n=28), zotarolimus-eluting stents (n=10), and bare-metal stents (n=13) were studied 10, 9, 9, 9, and 12 months after implantation, respectively. Endothelium-dependent Coronary Vasomotion was tested proximally and distally to the stent and at a reference vessel segment during atrial pacing at increasing heart rates by quantitative Coronary angiography. Indexes of platelet-monocyte binding and other biomarkers were studied in a subgroup of 19 patients. The baseline characteristics and hemodynamics of the patients in the different stent groups were comparable. Significant differences were observed across the 5 stent groups, concerning the Vasomotion of segments proximal ( P =0.006) and distal ( P =0.003) to the stent. Normal Vasomotion (vasodilatation) was maintained in the biolimus A9-eluting stent, zotarolimus-eluting stent, and bare-metal stent groups, whereas vasoconstriction was observed in the sirolimus-eluting stent and paclitaxel-eluting stent groups. Platelet-monocyte binding in whole blood showed a significant inverse correlation with Vasomotion in reference but not in segments adjacent to the stent ( r =−0.57; P =0.01). Conclusions— Paclitaxel-eluting stents and sirolimus-eluting stents seem to cause endothelial dysfunction of the implanted vessel, whereas biolimus A9-eluting stents and zotarolimus-eluting stents behave more closely to bare-metal stents, with preserved endothelial vasomotor response. Coronary vasoconstriction was not associated with detectable systemic endothelial activation. Received June 13, 2008; accepted October 27, 2008.
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differential effects of drug eluting stents on local endothelium dependent Coronary Vasomotion
Journal of the American College of Cardiology, 2008Co-Authors: Michalis Hamilos, Miodrag Ostojic, Dejan Orlic, Branco Beleslin, Dragan Sagic, Ljubco Mangovski, Sinisa Stojkovic, Milan Nedeljkovic, Bratislav Milosavljevic, Dragan TopicAbstract:Objectives The aim of our study was to compare Coronary Vasomotion after implantation of a second-generation biolimus A9-eluting stent (BES) and of a sirolimus-eluting stent (SES). Background Drug-eluting stents (DES) have been associated with impaired local Coronary Vasomotion, delayed endothelialization, and increased late thrombotic risk. New DES with different drugs, pharmacokinetics, and polymers have been developed. Methods Nineteen patients with a BES and 15 patients with a SES were studied 9 months after stent implantation. Endothelium-dependent and -independent Coronary Vasomotion were tested proximally and distally to the stent as well as at a reference segment during right atrial pacing at increasing heart rates. Quantitative Coronary angiographic measurements were performed offline. Results Of the patients with BES, 2 showed vasoconstriction with increased heart rate and 17 showed vasodilatation. Of the patients with a SES, 9 showed vasoconstriction while 6 showed vasodilatation. The SES showed significant vasoconstriction at both the proximal (−2.3 ± 10% vs. 7.9 ± 10%) and the distal (−5.4 ± 9% vs. 6.1 ± 8%) segments to the stent compared with the BES (p = 0.003 for proximal, p Conclusions Unlike the case with the SES, endothelium-dependent Vasomotion at adjacent stent segments seems to be preserved after BES implantation. This result may be explained by the different drug release kinetics, DES design, or characteristics of polymer used in the stent system.
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differential effects of drug eluting stents on local endothelium dependent Coronary Vasomotion commentary
Journal of the American College of Cardiology, 2008Co-Authors: Michalis Hamilos, Miodrag Ostojic, Dejan Orlic, Branco Beleslin, Dragan Sagic, Ljubco Mangovski, Sinisa Stojkovic, Milan Nedeljkovic, Bratislav Milosavljevic, Dragan TopicAbstract:Objectives The aim of our study was to compare Coronary Vasomotion after implantation of a second-generation biolimus A9-eluting stent (BES) and of a sirolimus-eluting stent (SES). Background Drug-eluting stents (DES) have been associated with impaired local Coronary Vasomotion, delayed endothelialization, and increased late thrombotic risk. New DES with different drugs, pharmacokinetics, and polymers have been developed. Methods Nineteen patients with a BES and 15 patients with a SES were studied 9 months after stent implantation. Endothelium-dependent and -independent Coronary Vasomotion were tested proximally and distally to the stent as well as at a reference segment during right atrial pacing at increasing heart rates. Quantitative Coronary angiographic measurements were performed offline. Results Of the patients with BES, 2 showed vasoconstriction with increased heart rate and 17 showed vasodilatation. Of the patients with a SES, 9 showed vasoconstriction while 6 showed vasodilatation. The SES showed significant vasoconstriction at both the proximal (-2.3 ± 10% vs. 7.9 ± 10%) and the distal (-5.4 ± 9% vs. 6.1 ± 8%) segments to the stent compared with the BES (p = 0.003 for proximal, p < 0.001 for distal segment). Endothelium-independent Vasomotion after intraCoronary nitrates did not differ significantly between the 2 groups (p = NS for proximal and distal segment). Conclusions Unlike the case with the SES, endothelium-dependent Vasomotion at adjacent stent segments seems to be preserved after BES implantation. This result may be explained by the different drug release kinetics, DES design, or characteristics of polymer used in the stent system.
Otto M Hess - One of the best experts on this subject based on the ideXlab platform.
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impact of exercise induced Coronary Vasomotion on anti ischemic therapy
Coronary Artery Disease, 2000Co-Authors: Philipp A Kaufmann, Christian Seiler, Lazar Mandinov, Otto M HessAbstract:Coronary Vasomotion has an important role in the regulation of myocardial perfusion. During dynamic exercise, normal Coronary arteries dilate, whereas stenotic arteries constrict. This exercise-induced vasoconstriction has been associated with the occurrence of myocardial ischemia and has been believed to be the result of endothelial dysfunction, with a reduced release or production of EDRF, increased sympathetic stimulation, enhanced platelet aggregation with release of thromboxane A2 and serotonin, or a passive collapse of the disease-free wall segment within the stenosis (the Bernoulli effect), or a combination of any of these. More recently, it has been realized that pharmacological treatment might prevent exercise-induced vasoconstriction and, thus, reduce myocardial ischemia and the occurrence of angina pectoris. Vasodilators such as nitrates, calcium antagonists or alpha-receptor blockers dilate the Coronary arteries and prevent Coronary stenosis narrowing during exercise. In contrast, beta-blocking agents are associated with Coronary vasoconstriction at rest, but--conversely--can induce Coronary vasodilatation during exercise. Pharmacological treatment in patients with stable angina pectoris may improve myocardial ischemia by reducing pre- and afterload, myocardial contractility, oxygen consumption, and vasomotor tone. However, Coronary collateral perfusion can modify these effects by shunting blood from the non-ischemic to the ischemic region (collateral flow) or by shunting blood from the ischemic to the non-ischemic zone (Coronary steal phenomenon). Typically, a steal phenomenon has been reported in patients receiving either dipyridamole or calcium antagonists, whereas a reversed steal has been described after beta-blockade, with an increase in contralateral tone shunting blood from the non-ischemic to the ischemic zone (reverse steal phenomenon).
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α adrenergic Coronary vasoconstriction and myocardial ischemia in humans
Circulation, 2000Co-Authors: Gerd Heusch, Otto M Hess, L Gregorini, William M Chilian, Dietrich Baumgart, Paolo G Camici, Ciro Indolfi, Ornella RimoldiAbstract:Abstract —The use of quantitative Coronary angiography, combined with Doppler and PET, has recently been directed at the study of α-adrenergic Coronary Vasomotion in humans. Confirming prior animal experiments, there is no evidence of α-adrenergic Coronary constrictor tone at rest. Again confirming prior experiments, responses to α-adrenoceptor activation are augmented in the presence of Coronary endothelial dysfunction and atherosclerosis, involving both α1- and α2-adrenoceptors in epicardial conduit arteries and microvessels. Such augmented α-adrenergic Coronary constriction is observed during exercise and Coronary interventions, and it is powerful enough to induce myocardial ischemia and limit myocardial function. Recent studies indicate a genetic determination of α2-adrenergic Coronary constriction.
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reversal of abnormal Coronary Vasomotion by calcium antagonists in patients with hypercholesterolemia
Circulation, 1998Co-Authors: Philipp A Kaufmann, Jurgen Frielingsdorf, Christian Seiler, Lazar Mandinov, Rosy Hug, Otto M HessAbstract:Background—It has been shown that exercise-induced Coronary vasodilation of angiographically normal Coronary vessels is reduced in hypercholesterolemic patients. The purpose of this study was to evaluate the effect of calcium channel blockers on Coronary Vasomotion of angiographically smooth Coronary arteries in hypercholesterolemic patients. Methods and Results—A total of 57 patients were included in the present analysis. Vasomotion of angiographically normal Coronary arteries was evaluated in 37 control subjects (group 1) without and 20 patients (group 2) with calcium blocker administration before physical exercise. Both groups were subdivided into subgroup A (normal cholesterol values: ≤5.5 mmol/L or 212 mg%) and subgroup B (elevated cholesterol values: >5.5 mmol/L or 212 mg%). Coronary luminal area at rest and during exercise was assessed by biplane quantitative Coronary angiography. The normal vessels showed a significant increase in Coronary luminal area during exercise in subgroup A (n=13) with nor...
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Coronary Vasomotion after percutaneous transluminal Coronary angioplasty depends on the severity of the culprit lesion
Journal of the American College of Cardiology, 1997Co-Authors: Lazar Mandinov, Philipp A Kaufmann, Daniel Staub, Thomas A Buckingham, F W Amann, Otto M HessAbstract:AbstractObjectives. This study sought to evaluate Coronary vasomotor response to percutaneous transluminal Coronary angioplasty (PTCA) and its influence on proximal and distal vessel diameters with...
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abnormal Coronary Vasomotion in hypertension role of Coronary artery disease
Journal of the American College of Cardiology, 1996Co-Authors: Jurgen Frielingsdorf, Philipp A Kaufmann, Giuseppe Vassalli, Christian Seiler, Thomas Suter, Otto M HessAbstract:Abstract Objectives. This study sought to evaluate the effect of dynamic exercise on Coronary Vasomotion in hypertensive patients in the presence and absence of Coronary artery disease. Background. Endothelial dysfunction with abnormal Coronary vasodilation in response to acetylcholine has been reported in patients with arterial hypertension. Methods. Coronary artery dimensions of a normal and stenotic vessel segment were determined in 64 patients by biplane quantitative Coronary arteriography at rest and during supine bicycle exercise. Patients were classified into two groups: 20 patients without evidence of Coronary artery disease (10 normotensive, 10 hypertensive [group 1]) and 44 patients with Coronary artery disease (26 normotensive, 18 hypertensive [group 2]). Both groups were comparable with regard to clinical characteristics, serum cholesterol levels, body mass index, exercise capacity and hemodynamic data. Results. Mean aortic pressure was significantly higher in hypertensive than normotensive patients. Exercise-induced vasodilation of the normal vessel segment was similar in normotensive and hypertensive patients without Coronary artery disease (group 1), namely, +19% versus +20%. However, in hypertensive patients with Coronary artery disease, exercise-induced vasodilation was significantly less in both normal and stenotic vessel segments than in normotensive subjects (+1% vs. +20% for normal [p Conclusions. In the absence of Coronary artery disease, the vasomotor response to exercise is normal in both normotensive and hypertensive patients. However, in hypertensive patients with Coronary artery disease, an abnormal response of the Coronary vessels can be observed, with a reduced vasodilator response to exercise in normal arteries but an enhanced vasoconstrictor response in stenotic arteries. This behavior of the epicardial vessels during exercise suggests the occurrence of endothelial dysfunction (i.e., functional defect) that is not evident in the absence of Coronary artery disease. Nitroglycerin reverses impaired Coronary vasodilation, but this effect is blunted in the presence of Coronary artery disease (i.e., structural defect).
Branco Beleslin - One of the best experts on this subject based on the ideXlab platform.
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interference of drug eluting stents with endothelium dependent Coronary Vasomotion evidence for device specific responses
Circulation-cardiovascular Interventions, 2008Co-Authors: Michalis Hamilos, Miodrag Ostojic, Giovanna Sarno, Thomas Cuisset, Emanuele Barbato, Jaydeep Sarma, Narbeh Melikian, Argyrios Ntalianis, Olivier Muller, Branco BeleslinAbstract:Background— There is evidence that endothelial coverage of drug-eluting stents might be delayed or absent, a risk factor for late thrombotic events. We studied the effects of different drug-polymer-device iterations on endothelium-dependent Coronary Vasomotion. Systemic markers of endothelial inflammation were correlated with Coronary vasomotor changes. Methods and Results— Patients with paclitaxel-eluting stents (n=11), sirolimus-eluting stents (n=21), biolimus A9-eluting stents (n=28), zotarolimus-eluting stents (n=10), and bare-metal stents (n=13) were studied 10, 9, 9, 9, and 12 months after implantation, respectively. Endothelium-dependent Coronary Vasomotion was tested proximally and distally to the stent and at a reference vessel segment during atrial pacing at increasing heart rates by quantitative Coronary angiography. Indexes of platelet-monocyte binding and other biomarkers were studied in a subgroup of 19 patients. The baseline characteristics and hemodynamics of the patients in the different stent groups were comparable. Significant differences were observed across the 5 stent groups, concerning the Vasomotion of segments proximal ( P =0.006) and distal ( P =0.003) to the stent. Normal Vasomotion (vasodilatation) was maintained in the biolimus A9-eluting stent, zotarolimus-eluting stent, and bare-metal stent groups, whereas vasoconstriction was observed in the sirolimus-eluting stent and paclitaxel-eluting stent groups. Platelet-monocyte binding in whole blood showed a significant inverse correlation with Vasomotion in reference but not in segments adjacent to the stent ( r =−0.57; P =0.01). Conclusions— Paclitaxel-eluting stents and sirolimus-eluting stents seem to cause endothelial dysfunction of the implanted vessel, whereas biolimus A9-eluting stents and zotarolimus-eluting stents behave more closely to bare-metal stents, with preserved endothelial vasomotor response. Coronary vasoconstriction was not associated with detectable systemic endothelial activation. Received June 13, 2008; accepted October 27, 2008.
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differential effects of drug eluting stents on local endothelium dependent Coronary Vasomotion
Journal of the American College of Cardiology, 2008Co-Authors: Michalis Hamilos, Miodrag Ostojic, Dejan Orlic, Branco Beleslin, Dragan Sagic, Ljubco Mangovski, Sinisa Stojkovic, Milan Nedeljkovic, Bratislav Milosavljevic, Dragan TopicAbstract:Objectives The aim of our study was to compare Coronary Vasomotion after implantation of a second-generation biolimus A9-eluting stent (BES) and of a sirolimus-eluting stent (SES). Background Drug-eluting stents (DES) have been associated with impaired local Coronary Vasomotion, delayed endothelialization, and increased late thrombotic risk. New DES with different drugs, pharmacokinetics, and polymers have been developed. Methods Nineteen patients with a BES and 15 patients with a SES were studied 9 months after stent implantation. Endothelium-dependent and -independent Coronary Vasomotion were tested proximally and distally to the stent as well as at a reference segment during right atrial pacing at increasing heart rates. Quantitative Coronary angiographic measurements were performed offline. Results Of the patients with BES, 2 showed vasoconstriction with increased heart rate and 17 showed vasodilatation. Of the patients with a SES, 9 showed vasoconstriction while 6 showed vasodilatation. The SES showed significant vasoconstriction at both the proximal (−2.3 ± 10% vs. 7.9 ± 10%) and the distal (−5.4 ± 9% vs. 6.1 ± 8%) segments to the stent compared with the BES (p = 0.003 for proximal, p Conclusions Unlike the case with the SES, endothelium-dependent Vasomotion at adjacent stent segments seems to be preserved after BES implantation. This result may be explained by the different drug release kinetics, DES design, or characteristics of polymer used in the stent system.
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differential effects of drug eluting stents on local endothelium dependent Coronary Vasomotion commentary
Journal of the American College of Cardiology, 2008Co-Authors: Michalis Hamilos, Miodrag Ostojic, Dejan Orlic, Branco Beleslin, Dragan Sagic, Ljubco Mangovski, Sinisa Stojkovic, Milan Nedeljkovic, Bratislav Milosavljevic, Dragan TopicAbstract:Objectives The aim of our study was to compare Coronary Vasomotion after implantation of a second-generation biolimus A9-eluting stent (BES) and of a sirolimus-eluting stent (SES). Background Drug-eluting stents (DES) have been associated with impaired local Coronary Vasomotion, delayed endothelialization, and increased late thrombotic risk. New DES with different drugs, pharmacokinetics, and polymers have been developed. Methods Nineteen patients with a BES and 15 patients with a SES were studied 9 months after stent implantation. Endothelium-dependent and -independent Coronary Vasomotion were tested proximally and distally to the stent as well as at a reference segment during right atrial pacing at increasing heart rates. Quantitative Coronary angiographic measurements were performed offline. Results Of the patients with BES, 2 showed vasoconstriction with increased heart rate and 17 showed vasodilatation. Of the patients with a SES, 9 showed vasoconstriction while 6 showed vasodilatation. The SES showed significant vasoconstriction at both the proximal (-2.3 ± 10% vs. 7.9 ± 10%) and the distal (-5.4 ± 9% vs. 6.1 ± 8%) segments to the stent compared with the BES (p = 0.003 for proximal, p < 0.001 for distal segment). Endothelium-independent Vasomotion after intraCoronary nitrates did not differ significantly between the 2 groups (p = NS for proximal and distal segment). Conclusions Unlike the case with the SES, endothelium-dependent Vasomotion at adjacent stent segments seems to be preserved after BES implantation. This result may be explained by the different drug release kinetics, DES design, or characteristics of polymer used in the stent system.
Dejan Orlic - One of the best experts on this subject based on the ideXlab platform.
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Coronary Vasomotion one year after drug eluting stent implantation comparison of everolimus eluting and paclitaxel eluting Coronary stents
Journal of Cardiovascular Translational Research, 2014Co-Authors: Michalis Hamilos, Flavio Ribichini, Miodrag Ostojic, Valeria Ferrero, Dejan Orlic, Corrado Vassanelli, Nevena Karanovic, Giovanna Sarno, Thomas Cuisset, Panos E VardasAbstract:First-generation drug-eluting stents (DES) have been associated with impaired localized Coronary Vasomotion and delayed endothelialization. We aimed to compare Coronary Vasomotion after implantation of a newer-generation everolimus-eluting stent (EES), with a first-generation paclitaxel-eluting stent (PES). Coronary Vasomotion was studied in 19 patients with EES and 13 with PES. Vasomotor response was measured proximally and distally to the stent and in a remote vessel (reference segment). Quantitative Coronary angiography was performed offline. Endothelium independent Vasomotion did not differ significantly between the two groups. EES showed significant vasodilatation while PES showed vasoconstriction at both proximal (+4.5 ± 3.6 vs −4.2 ± 6.9, p < 0.001) and distal (+4.6 ± 7.9 vs −4.8 ± 9.3, p = 0.003) segments. The reference segment did not show any significant difference in vasodilatation between the two groups (+9.8 ± 6.4 vs +7.2 ± 5.2, p = 0.17). Endothelium-dependent Vasomotion at adjacent stent segments is relatively preserved after EES implantation while vasoconstriction was observed after PES implantation.
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Coronary Vasomotion one year after drug-eluting stent implantation: comparison of everolimus-eluting and paclitaxel-eluting Coronary stents.
'Springer Science and Business Media LLC', 2014Co-Authors: Michalis Hamilos, Valeria Ferrero, Dejan Orlic, Nevena Karanovic, Giovanna Sarno, Thomas Cuisset, Ribichini, Flavio Luciano, C. M. Ostojic, Vassanelli Corrado, E. P. VardasAbstract:First-generation drug-eluting stents (DES) have been associated with impaired localized Coronary Vasomotion and delayed endothelialization. We aimed to compare Coronary Vasomotion after implantation of a newer-generation everolimus-eluting stent (EES), with a first-generation paclitaxel-eluting stent (PES). Coronary Vasomotion was studied in 19 patients with EES and 13 with PES. Vasomotor response was measured proximally and distally to the stent and in a remote vessel (reference segment). Quantitative Coronary angiography was performed offline. Endothelium independent Vasomotion did not differ significantly between the two groups. EES showed significant vasodilatation while PES showed vasoconstriction at both proximal (+4.5\u2009\ub1\u20093.6 vs -4.2\u2009\ub1\u20096.9, p\u2009
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differential effects of drug eluting stents on local endothelium dependent Coronary Vasomotion
Journal of the American College of Cardiology, 2008Co-Authors: Michalis Hamilos, Miodrag Ostojic, Dejan Orlic, Branco Beleslin, Dragan Sagic, Ljubco Mangovski, Sinisa Stojkovic, Milan Nedeljkovic, Bratislav Milosavljevic, Dragan TopicAbstract:Objectives The aim of our study was to compare Coronary Vasomotion after implantation of a second-generation biolimus A9-eluting stent (BES) and of a sirolimus-eluting stent (SES). Background Drug-eluting stents (DES) have been associated with impaired local Coronary Vasomotion, delayed endothelialization, and increased late thrombotic risk. New DES with different drugs, pharmacokinetics, and polymers have been developed. Methods Nineteen patients with a BES and 15 patients with a SES were studied 9 months after stent implantation. Endothelium-dependent and -independent Coronary Vasomotion were tested proximally and distally to the stent as well as at a reference segment during right atrial pacing at increasing heart rates. Quantitative Coronary angiographic measurements were performed offline. Results Of the patients with BES, 2 showed vasoconstriction with increased heart rate and 17 showed vasodilatation. Of the patients with a SES, 9 showed vasoconstriction while 6 showed vasodilatation. The SES showed significant vasoconstriction at both the proximal (−2.3 ± 10% vs. 7.9 ± 10%) and the distal (−5.4 ± 9% vs. 6.1 ± 8%) segments to the stent compared with the BES (p = 0.003 for proximal, p Conclusions Unlike the case with the SES, endothelium-dependent Vasomotion at adjacent stent segments seems to be preserved after BES implantation. This result may be explained by the different drug release kinetics, DES design, or characteristics of polymer used in the stent system.
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differential effects of drug eluting stents on local endothelium dependent Coronary Vasomotion commentary
Journal of the American College of Cardiology, 2008Co-Authors: Michalis Hamilos, Miodrag Ostojic, Dejan Orlic, Branco Beleslin, Dragan Sagic, Ljubco Mangovski, Sinisa Stojkovic, Milan Nedeljkovic, Bratislav Milosavljevic, Dragan TopicAbstract:Objectives The aim of our study was to compare Coronary Vasomotion after implantation of a second-generation biolimus A9-eluting stent (BES) and of a sirolimus-eluting stent (SES). Background Drug-eluting stents (DES) have been associated with impaired local Coronary Vasomotion, delayed endothelialization, and increased late thrombotic risk. New DES with different drugs, pharmacokinetics, and polymers have been developed. Methods Nineteen patients with a BES and 15 patients with a SES were studied 9 months after stent implantation. Endothelium-dependent and -independent Coronary Vasomotion were tested proximally and distally to the stent as well as at a reference segment during right atrial pacing at increasing heart rates. Quantitative Coronary angiographic measurements were performed offline. Results Of the patients with BES, 2 showed vasoconstriction with increased heart rate and 17 showed vasodilatation. Of the patients with a SES, 9 showed vasoconstriction while 6 showed vasodilatation. The SES showed significant vasoconstriction at both the proximal (-2.3 ± 10% vs. 7.9 ± 10%) and the distal (-5.4 ± 9% vs. 6.1 ± 8%) segments to the stent compared with the BES (p = 0.003 for proximal, p < 0.001 for distal segment). Endothelium-independent Vasomotion after intraCoronary nitrates did not differ significantly between the 2 groups (p = NS for proximal and distal segment). Conclusions Unlike the case with the SES, endothelium-dependent Vasomotion at adjacent stent segments seems to be preserved after BES implantation. This result may be explained by the different drug release kinetics, DES design, or characteristics of polymer used in the stent system.
