DOI QR코드

DOI QR Code

Effect of a Dual Drug-Coated Stent With Abciximab and Alpha-Lipoic Acid in a Porcine Coronary Restenosis Model

  • Lim, Kyung-Seob (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Hong, Young-Joon (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Hachinohe, Daisuke (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Ahmed, Khurshid (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Jeong, Myung-Ho (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Kim, Jung-Ha (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Sim, Doo-Sun (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Lee, Min-Goo (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Park, Keun-Ho (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Kim, Ju-Han (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Ahn, Young-Keun (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Cho, Jeong-Gwan (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Park, Jong-Chun (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare) ;
  • Song, Sun-Jung (Center for Functional Nano Fine Chemicals & School of Applied Chemical Engineering, Chonnam National University) ;
  • Jung, Kyoung-Woon (Center for Functional Nano Fine Chemicals & School of Applied Chemical Engineering, Chonnam National University) ;
  • Cho, Dong-Lyun (Center for Functional Nano Fine Chemicals & School of Applied Chemical Engineering, Chonnam National University) ;
  • Kang, Jung-Chaee (The Heart Research Center of Chonnam National University Hospital Designated by Korea Ministry of Health and Welfare)
  • Published : 2011.05.30

Abstract

Background and Objectives: The aim of this study was to examine the anti-proliferative and anti-inflammatory effects of a stent coated with abciximab and alpha-lipoic acid (ALA) in a porcine coronary overstretch restenosis model. Materials and Methods: A total of 10 pigs were randomized into two groups (10 pigs, 10 coronaries in each group) in which the coronary arteries were stented with a dual-coated stent and a bare metal stent (control) by randomization. Stents were deployed with oversizing (stent/artery ratio 1.3 : 1) in the porcine coronary arteries, and histopathology was assessed 28 days after stenting. Results: There was no significant difference in the injury score between the two groups. In the neointima, the lymphohistiocyte count was significantly lower in dual-coat stent group compared with the control stent group (120${\pm}$85 cells vs. 159${\pm}$80 cells, p=0.048). There was no significant difference in the fibrin score between the two groups (0.16${\pm}$0.34 in the dual-coated stent group vs. 0.25${\pm}$0.48 in the control stent group, p=0.446). The neointima area was not significantly different between both groups (1.55${\pm}$0.8 $mm^2$ in dual-coated stent group vs. 1.40${\pm}$0.86 $mm^2$ in the control stent group, p=0.447). Conclusion: Although the dual-coated stent with abciximab and ALA showed no significant difference in inhibition of neointimal hyperplasia when compared with the bare metal stent, it was associated with a reduced inflammatory reaction when compared with the control stent in a porcine coronary restenosis model.

Keywords

References

  1. Eekhout E, Wijns W, Meier B, Goy JJ. Indications for coronary stent placement: the European view. Eur Heart J 1999;20:1014-9. https://doi.org/10.1053/euhj.1998.1395
  2. Faxon DP, Spiro TE, Minor S, et al. Low molecular weight heparin in prevention of restenosis after angioplasty. Results of Enoxaparin Restenosis (ERA) Trial. Circulation 1994;90:908-14. https://doi.org/10.1161/01.CIR.90.2.908
  3. Hamm CW, Reimers J, Ischinger T, Rupprecht HJ, Berger J, Bleifeld W. A randomized study of coronary angioplasty compared with bypass surgery in patients with symptomatic multivessel coronary disease. Ger-man Angioplasty Bypass Surgery Investigation (GABI). N Engl J Med 1994;331:1037-43. https://doi.org/10.1056/NEJM199410203311601
  4. Kent KM, Bentivoglio LG, Block PC, et al. Longterm efficacy of percutaneous transluminal coronary angioplasty (PTCA): report from the National Heart, Lung, and Blood Institute PTCA Registry. Am J Cardiol 1984;53:27C-31C. https://doi.org/10.1016/0002-9149(84)90741-0
  5. Forrester JS, Fishbein M, Helfant R, Fagin J. A paradigm for restenosis based on cell biology: clues for the development of new preventive therapies. J Am Coll Cardiol 1991;17:758-69. https://doi.org/10.1016/S0735-1097(10)80196-2
  6. Austin GE, Ratliff NB, Hollman J, Tabei S, Phillips DF. Intimal proli-feration of smooth muscle cells as an explanation for recurrent coronary artery stenosis after percutaneous transluminal coronary angioplasty. J Am Coll Cardiol 1985;6:369-75. https://doi.org/10.1016/S0735-1097(85)80174-1
  7. Bae Y, Jeong MH, Ahn YK, et al. Comparison of porcine coronary st-ent restenosis between MAC (Maximal Arterial Re-Creation) stent and Palmaz-Schatz stent. Korean Circ J 1998;28:89-96.
  8. Giraldo AA, Esposo OM, Meis JM. Intimal hyperplasia as a cause of restenosis after percutaneous transluminal coronary angioplasty. Arch Pathol Lab Med 1985;109:173-5.
  9. Ahn YK, Jeong MH, Kim JW, et al. Preventive effects of the heparincoated stent on restenosis in the porcine model. Catheter Cardiovasc Interv 1999;48:324-30. https://doi.org/10.1002/(SICI)1522-726X(199911)48:3<324::AID-CCD20>3.0.CO;2-K
  10. Hong YJ, Jeong MH, Lim SY, et al. Elevated preprocedural high-sensitivity C-reactive protein levels are associated with neointimal hyperplasia and restenosis development after successful coronary artery st-enting. Circ J 2005;69:1477-83. https://doi.org/10.1253/circj.69.1477
  11. The CAPTURE Investigators. Randomized placebo-controlled trial of abciximab before and during coronary intervention in refractory angina. Lancet 1997;349:1429-35. https://doi.org/10.1016/S0140-6736(96)10452-9
  12. The EPILOG Investigators. Platelet glycoprotein IIb / IIIa blockade and low-dose heparin during percutaneous coronary revascularisation. N Engl J Med 1997;336:1689-96. https://doi.org/10.1056/NEJM199706123362401
  13. Lefkovits J, Ivanhoe RJ, Califf RM, et al. Effects of platelet glycoprotein IIb/IIIa receptor blockade by a chimeric monoclonal antibody (abciximab) on acute and six-month outcomes after percutaneous tr-ansluminal coronary angioplasty for acute myocardial infarction. Am J Cardiol 1996;77:1045-51. https://doi.org/10.1016/S0002-9149(96)00128-2
  14. Topol EJ, Ferguson JJ, Weisman HF, et al. Long term protection from myocardial ischaemic events in a randomised trial of brief integrin beta3 blockade with percutaneous coronary intervention. JAMA 1997;278:479-84. https://doi.org/10.1001/jama.1997.03550060055036
  15. Packer L, Witt EH, Tritschler HJ. Alpha-lipoic acid as a biological an-tioxidant. Free Radic Biol Med 1995;19:227-50. https://doi.org/10.1016/0891-5849(95)00017-R
  16. Packer L, Roy S, Sen CK. Alpha-lipoic acid: a metabolic antioxidant and potential redox modulator of transcription. Adv Pharmacol 1997;38:79-101.
  17. Song SJ, Kim KS, Park YJ, Jeong MH, Ko YM, Cho DL. Preparation of a dual-drug-eluting stent by grafting of ALA with abciximab on a bare metal stent. J Mater Chem 2009;19:8135-41. https://doi.org/10.1039/b910351a
  18. Schwartz RS, Huber KC, Murphy JG, et al. Restenosis and the proportional neointimal response to coronary artery injury: results in a por-cine model. J Am Coll Cardiol 1992;19:267-74. https://doi.org/10.1016/0735-1097(92)90476-4
  19. Schwartz RS, Edelman E, Virmani R, et al. Drug-eluting stents in pre-clinical studies: updated consensus recommendations for preclinical evaluation. Circ Cardiovasc Interv 2008;1:143-53. https://doi.org/10.1161/CIRCINTERVENTIONS.108.789974
  20. Kolodgie FD, John M, Khurana C, et al. Sustained reduction of in-stent neointimal growth with the use of a novel systemic nanoparticle paclitaxel. Circulation 2002;106:1195-8. https://doi.org/10.1161/01.CIR.0000032141.31476.15
  21. Lincoff AM. Potent complementary clinical benefit of abciximab and stenting during percutaneous coronary revascularization in patients with diabetes mellitus: results of the EPISTENT trial. Am Heart J 2000;139:S46-52. https://doi.org/10.1067/mhj.2000.103743
  22. Kang KT, Jeong MH, Kim NH, et al. The inhibitory effect of platelet glycoprotein IIb/IIIa receptor blocker-coated stent on porcine coronary stent restenosis. Korean J Med 2001;60:314-23.
  23. Park OY, Jeong MH, Kim JH, et al. The inhibitory effects of platelet glycoprotein IIb/IIIa receptor blocker-coated stent on neointima formation and inflammatory response in porcine coronary stent restenosis. Korean Circ J 2003;33:439-45.
  24. Hong YJ, Jeong MH, Kim W, et al. The effects of abciximab (Reopro(r))-coated stents on extracellular matrix synthesis and apoptosis. Korean Circ J 2005;35:290-301.
  25. Hong YJ, Jeong MH, Kim W, et al. Effect of abciximab-coated stent on in-stent intimal hyperplasia in human coronary arteries. Am J Cardiol 2004;94:1050-4. https://doi.org/10.1016/j.amjcard.2004.06.066
  26. Kim W, Jeong MH, Kim KH, et al. The clinical results of a platelet glycoprotein IIb/IIIa receptor blocker (abciximab: Reo-Pro)-coated stent in acute myocardial infarction. J Am Coll Cardiol 2006;47:933-8. https://doi.org/10.1016/j.jacc.2005.10.054
  27. Ziegler D, Hanefeld M, Ruhnau KJ, et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: a 7-month multicenter randomized controlled trial (ALADIN III Study). ALADIN III Study Group. Alpha-Lipoic Acid in Diabetic Neuropathy. Diabetes Care 1999;22:1296-301. https://doi.org/10.2337/diacare.22.8.1296
  28. Sung MJ, Kim W, Ahn SY, et al. Protective effect of alpha-lipoic acid in lipopolysaccharide-induced endothelial fractalkine expression. Circ Res 2005;97:880-90. https://doi.org/10.1161/01.RES.0000186522.89544.4D
  29. Lim SY, Bae EH, Jeong MH, et al. The effect of alpha lipoic acid in a porcine in-stent restenosis model. J Cardiol 2009;54:375-85. https://doi.org/10.1016/j.jjcc.2009.06.005
  30. Park OY, Jeong MH, Kim JH, et al. The role of extracellular matrix within the neointima in a porcine coronary stent restenosis model. Korean Circ J 2003;33:121-9.

Cited by

  1. Effect of stents coated with a combination of sirolimus and alpha-lipoic acid in a porcine coronary restenosis model vol.27, pp.4, 2011, https://doi.org/10.1007/s10856-015-5622-0
  2. Optimal Coating Method for a Dual-Layer Stent with Sirolimus and Alpha-Lipoic Acid in a Porcine Coronary Restenosis Model vol.24, pp.8, 2011, https://doi.org/10.1007/s13233-016-4082-9
  3. Long-term preclinical evaluation of bioabsorbable polymer-coated drug-eluting stent in a porcine model vol.25, pp.7, 2011, https://doi.org/10.1007/s13233-017-5067-z
  4. Poly-l-lactide Polymer-Based Triple Drug-Eluting Stent with Abciximab, Alpha-Lipoic Acid and Sirolimus in Porcine Coronary Restenosis Model vol.28, pp.1, 2011, https://doi.org/10.1007/s13233-020-8004-5