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| A Platelet Glycoprotein IIb/IIIa Receptor Blocker (ReoPro®)-Coated Coronary Stents Inhibit Cell Proliferation and Extracellular Matrix Synthesis in A Porcine Coronary Stent Restenosis Model |
| The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Science, Gwangju, Korea |
| Young Joon Hong, Myung Ho Jeong, Weon Kim, Sang Yup Lim, Sang Hyun Lee, Seo Na Hong, Kyung Ho Yun, Kye Hun Kim, Dong Goo Kang, Yeon Sang Lee, Ju Han Kim, Young Keun Ahn, Jeong Gwan Cho, Jong Chun Park, and Jung Chaee Kang |
Background: Neointimal cell proliferation and extracellular matrix (ECM) synthesis may be important in the induction of NIH.
Objectives: The effects of platelet glycoprotein IIb/IIIa receptor blocker (ReoPro®)-coated stent on cell proliferation and extracellular matrix synthesis in coronary stent restenosis was observed.
Methods: Twenty one ReoPro®-coated stents and 21 control stents were placed in 21 pigs, and histopathologic analyses for 7 stented arteries were performed at 14 days, 28 days and 56 days after stenting respectively. Each specimen was analyzed by the methods of hematoxylin and eosin, modified Movat and Masson-Trichrome staining. Immunohistochemical staining using monoclonal antibodies for smooth muscle α-actin and proliferating cell nuclear antigen (PCNA) was performed. Histopathologic assessment was performed using a Visus 2000 Visual Image Analysis System.
Results: The area of neointima of ReoPro®-coated stents was reduced to 45.7% and 45.5% of the control stents at 28 days and 56 days after stenting(1.9±0.5 vs. 3.5±0.7, 2.4±0.5 vs. 4.4±0.6 mm2, p=0.012, 0.001, respectively). The content ratio of proteoglycan within the neointima of ReoPro®-coated stents was reduced to 23% of the control stents at 14 days after stenting(p=0.041). The content ratio of collagen within the neointima of ReoPro®-coated stents was reduced to 19.7% and 25% of the control stents at 28 days and 56 days after stenting(p=0.021, 0.001, respectively). PCNA index of neointima of ReoPro®-coated stents was reduced to 22.2% of the control stents at 14 days after stenting(p=0.022). Alpha-actin was positive in the cells of neointima in two groups and the percentage of positive cells of α-actin was increased after stenting in two groups and ReoPro®-coated stents inhibit smooth muscle cell proliferation effectively during entire period after stenting.
Conclusion: The ReoPro®-coated stent reduces stent restenosis by inhibition of cell proliferation and proteoglycan synthesis in the early period and by inhibition of collagen synthesis in the late period and by inhibition of smooth muscle cell proliferation during entire period after stenting in a porcine coronary restenosis model.
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