期刊
AMERICAN JOURNAL OF CARDIOLOGY
卷 182, 期 -, 页码 1-7出版社
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjcard.2022.07.038
关键词
-
资金
- nonconditional grant from Abbott Vascular (Spain)
This study followed up patients treated with ABSORB-BVS for 5 years and found that while the absorbed scaffolds demonstrated complete structural healing, there were impaired vasomotor responses in the treated segments.
Although complete bioresorbable vascular scaffold (BVS) resorption has been demon-strated at 5-year follow-up, whether corresponding vasomotor function restoration occurs remains unknown. The objective was to simultaneously assess the structural healing response along with vasomotor responses at 5-year follow-up of BVS implantation. We studied consecutive patients treated with ABSORB-BVS at 5-year follow-up (n = 31), who were recruited from a multicenter registry and were contacted to undergo a research pro-tocol-driven repeat coronary angiogram involving intracoronary optical coherence tomog-raphy (OCT) and invasive coronary endothelial function testing. Epicardial endothelium -dependent vasomotion was defined as any vasodilatation after intracoronary acetylcholine (ACh), whereas endothelium-independent vasomotion was defined as any vasodilatation after intracoronary nitroglycerine (NTG), using quantitative coronary angiography. The mean implantation time point was 60.5 +/- 4.6 months. OCT imaging demonstrated com-plete scaffold resorption in all patients. New coronary lesions (stenosis >50%) were found in 5 patients (16.1%), 3 of them underwent ad hoc percutaneous revascularization (9.7%). Intracoronary ACh (27 patients) and NTG testing (30 patients) was performed. Quantita-tive coronary angiography analysis demonstrated vasoconstriction after ACh administra-tion and lack of response to NTG in BVS segments (mean lumen diameter = 2.00 +/- 0.61 mm at baseline vs 1.74 +/- 0.70 mm post-ACh, p <0.001; 2.05 +/- 0.54 mm at baseline vs 2.03 +/- 0.50 mm post-NTG, p = 0.69). OCT lumen analysis demonstrated similar vasocon-strictive responses to ACh (mean lumen area = 5.31 +/- 2.26 mm2 at baseline vs 5.12 +/- 2.55 mm2 post-ACh, p = 0.007) but had a vasodilatory response to NTG (5.96 +/- 2.35 mm2 at baseline vs 6.17 +/- 2.55 mm2 post-NTG, p<0.001). In conclusion, complete ABSORB-BVS resorption was demonstrated at 5-year follow-up. However, this healing response was associated with endothelium-dependent vasomotor dysfunction within the BVS seg-ment. (c) 2022 Elsevier Inc. All rights reserved. (Am J Cardiol 2022;182:1-7)
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