Very Late Vasomotor Responses and Gene Expression with Bioresorbable Scaffolds and Metallic Drug-eluting Stents

Overview

Journal Catheter Cardiovasc Interv

Specialty Cardiology & Vascular Diseases

Date 2021 Jun 24

PMID 34164905

Authors

Jin-Sin Koh

Bill D Gogas

Sandeep Kumar

James J Benham

Sanjoli Sur

Nikolaos Spilias

Arnav Kumar

Don P Giddens

Richard Rapoza

Dean J Kereiakes

Gregg Stone

Hanjoong Jo

Habib Samady

Affiliations

Soon will be listed here.

Abstract

Objectives: To investigate the long-term vasomotor response and inflammatory changes in Absorb bioresorbable vascular scaffold (BVS) and metallic drug-eluting stent (DES) implanted artery.

Background: Clinical evidence has demonstrated that compared to DES, BVS is associated with higher rates of target lesion failure. However, it is not known whether the higher event rates observed with BVS are related to endothelial dysfunction or inflammation associated with polymer degradation.

Methods: Ten Absorb BVS and six Xience V DES were randomly implanted in the main coronaries of six nonatherosclerotic swine. At 4-years, vasomotor response was evaluated in vivo by quantitative coronary angiography response to intracoronary infusion of Ach and ex vivo by the biomechanical response to prostaglandin F2-α (PGF2-α), substance P and bradykinin and gene expression analysis.

Results: Absorb BVS implanted arteries showed significantly restored vasoconstrictive responses after Ach compared to in-stent Xience V. The contractility of Absorb BVS treated segments induced by PGF2-α was significantly greater compared to Xience V treated segments and endothelial-dependent vasorelaxation was greater with Absorb BVS compared to Xience V. Gene expression analyses indicated the pro-inflammatory lymphotoxin-beta receptor (LTβR) signaling pathway was significantly upregulated in arteries treated with a metallic stent compared to Absorb BVS treated arterial segments.

Conclusions: At 4 years, arteries treated with Absorb BVS compared with Xience V, demonstrate significantly greater restoration of vasomotor responses. Genetic analysis suggests mechanobiologic reparation of Absorb BVS treated arteries at 4 years as opposed to Xience V treated vessels.

References

Sotomi Y, Onuma Y, Collet C, Tenekecioglu E, Virmani R, Kleiman N . Bioresorbable Scaffold: The Emerging Reality and Future Directions. Circ Res. 2017; 120(8):1341-1352. DOI: 10.1161/CIRCRESAHA.117.310275. View

Galkina E, Ley K . Vascular adhesion molecules in atherosclerosis. Arterioscler Thromb Vasc Biol. 2007; 27(11):2292-301. DOI: 10.1161/ATVBAHA.107.149179. View

Nakazawa G, Otsuka F, Nakano M, Vorpahl M, Yazdani S, Ladich E . The pathology of neoatherosclerosis in human coronary implants bare-metal and drug-eluting stents. J Am Coll Cardiol. 2011; 57(11):1314-22. PMC: 3093310. DOI: 10.1016/j.jacc.2011.01.011. View

Libby P . Inflammation in atherosclerosis. Arterioscler Thromb Vasc Biol. 2012; 32(9):2045-51. PMC: 3422754. DOI: 10.1161/ATVBAHA.108.179705. View

Gogas B, Benham J, Hsu S, Sheehy A, Lefer D, Goodchild T . Vasomotor Function Comparative Assessment at 1 and 2 Years Following Implantation of the Absorb Everolimus-Eluting Bioresorbable Vascular Scaffold and the Xience V Everolimus-Eluting Metallic Stent in Porcine Coronary Arteries: Insights From In Vivo.... JACC Cardiovasc Interv. 2016; 9(7):728-41. DOI: 10.1016/j.jcin.2015.12.018. View

Graser T, Leisner H, TIEDT N . Absence of role of endothelium in the response of isolated porcine coronary arteries to acetylcholine. Cardiovasc Res. 1986; 20(4):299-302. DOI: 10.1093/cvr/20.4.299. View

Gogas B, McDaniel M, Samady H, King 3rd S . Novel drug-eluting stents for coronary revascularization. Trends Cardiovasc Med. 2014; 24(7):305-13. DOI: 10.1016/j.tcm.2014.07.004. View

Stone G, Ellis S, Gori T, Metzger D, Stein B, Erickson M . Blinded outcomes and angina assessment of coronary bioresorbable scaffolds: 30-day and 1-year results from the ABSORB IV randomised trial. Lancet. 2018; 392(10157):1530-1540. DOI: 10.1016/S0140-6736(18)32283-9. View

Aukrust P, Halvorsen B, Yndestad A, Ueland T, Oie E, Otterdal K . Chemokines and cardiovascular risk. Arterioscler Thromb Vasc Biol. 2008; 28(11):1909-19. DOI: 10.1161/ATVBAHA.107.161240. View

10.

Otsuka F, Pacheco E, Perkins L, Lane J, Wang Q, Kamberi M . Long-term safety of an everolimus-eluting bioresorbable vascular scaffold and the cobalt-chromium XIENCE V stent in a porcine coronary artery model. Circ Cardiovasc Interv. 2014; 7(3):330-42. DOI: 10.1161/CIRCINTERVENTIONS.113.000990. View

11.

Chen D, Su Z, Weng L, Cao L, Chen C, Zeng S . Effect of inflammation on endothelial cells induced by poly-L-lactic acid degradation in vitro and in vivo. J Biomater Sci Polym Ed. 2018; 29(15):1909-1919. DOI: 10.1080/09205063.2018.1517858. View

12.

Yamaji K, Ueki Y, Souteyrand G, Daemen J, Wiebe J, Nef H . Mechanisms of Very Late Bioresorbable Scaffold Thrombosis: The INVEST Registry. J Am Coll Cardiol. 2017; 70(19):2330-2344. DOI: 10.1016/j.jacc.2017.09.014. View

13.

Jufri N, Mohamedali A, Avolio A, Baker M . Mechanical stretch: physiological and pathological implications for human vascular endothelial cells. Vasc Cell. 2015; 7:8. PMC: 4575492. DOI: 10.1186/s13221-015-0033-z. View

14.

Tsoi S, Zhou C, Grant J, Pasternak J, Dobrinsky J, Rigault P . Development of a porcine (Sus scofa) embryo-specific microarray: array annotation and validation. BMC Genomics. 2012; 13:370. PMC: 3468353. DOI: 10.1186/1471-2164-13-370. View

15.

Stone G, Gao R, Kimura T, Kereiakes D, Ellis S, Onuma Y . 1-year outcomes with the Absorb bioresorbable scaffold in patients with coronary artery disease: a patient-level, pooled meta-analysis. Lancet. 2016; 387(10025):1277-89. DOI: 10.1016/S0140-6736(15)01039-9. View

16.

Stone G, Kimura T, Gao R, Kereiakes D, Ellis S, Onuma Y . Time-Varying Outcomes With the Absorb Bioresorbable Vascular Scaffold During 5-Year Follow-up: A Systematic Meta-analysis and Individual Patient Data Pooled Study. JAMA Cardiol. 2019; 4(12):1261-1269. PMC: 6777269. DOI: 10.1001/jamacardio.2019.4101. View

17.

Serruys P, Chevalier B, Sotomi Y, Cequier A, Carrie D, Piek J . Comparison of an everolimus-eluting bioresorbable scaffold with an everolimus-eluting metallic stent for the treatment of coronary artery stenosis (ABSORB II): a 3 year, randomised, controlled, single-blind, multicentre clinical trial. Lancet. 2016; 388(10059):2479-2491. DOI: 10.1016/S0140-6736(16)32050-5. View

18.

Gogas B, Yang B, Passerini T, Veneziani A, Piccinelli M, Esposito G . Computational fluid dynamics applied to virtually deployed drug-eluting coronary bioresorbable scaffolds: Clinical translations derived from a proof-of-concept. Glob Cardiol Sci Pract. 2015; 2014(4):428-36. PMC: 4355516. DOI: 10.5339/gcsp.2014.56. View

19.

Stone G, Abizaid A, Onuma Y, Seth A, Gao R, Ormiston J . Effect of Technique on Outcomes Following Bioresorbable Vascular Scaffold Implantation: Analysis From the ABSORB Trials. J Am Coll Cardiol. 2017; 70(23):2863-2874. DOI: 10.1016/j.jacc.2017.09.1106. View

20.

Ito T, Ikeda U . Inflammatory cytokines and cardiovascular disease. Curr Drug Targets Inflamm Allergy. 2003; 2(3):257-65. DOI: 10.2174/1568010033484106. View