Effects of combined therapy with ezetimibe plus simvastatin after drug-eluting stent implantation in a porcine coronary restenosis model

J Korean Med Sci. 2010 May;25(5):716-22. doi: 10.3346/jkms.2010.25.5.716. Epub 2010 Apr 16.

Abstract

The aim of this study was to examine the anti-proliferative and anti-inflammatory effects of ezetimibe/simvastatin (E/S) after drug-eluting stent (DES) implantation in a porcine coronary restenosis model. Pigs were randomized into two groups in which the coronary arteries (23 pigs) had DES. Stents were deployed with oversizing (stent/artery ratio 1.3:1) in porcine coronary arteries. Fifteen pigs were taken 10/20 mg of E/S and eight pigs were not taken E/S. Histopathologic analysis was assessed at 28 days after stenting. In neointima, most inflammatory cells were lymphohistiocytes. Lymphohistiocyte count was not different between two groups (337+/-227 vs. 443+/-366 cells, P=0.292), but neointima area was significantly smaller (1.00+/-0.49 mm(2) vs. 1.69+/-0.98 mm(2), P=0.021) and percent area stenosis was significantly lower (23.3+/-10% vs. 39+/-19%, P=0.007) in E/S group compared with control group. There were no significant differences in fibrin score (1.99+/-0.79 vs. 1.81+/-0.88, P=0.49), endothelial score (1.75+/-0.66 vs. 1.80+/-0.59, P=0.79), and the percent of endothelium covered lumen (43+/-21% vs. 45+/-21%, P=0.84) between E/S group and control group. Combined therapy with ezetimibe and simvastatin inhibits neointimal hyperplasia, but does not inhibit inflammatory infiltration and arterial healing after DES implantation in a porcine coronary restenosis model.

Keywords: Endothelization; Inflammation; Restenosis; Stents.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anticholesteremic Agents / administration & dosage
  • Azetidines / administration & dosage*
  • Coronary Restenosis / diagnosis
  • Coronary Restenosis / drug therapy
  • Coronary Restenosis / etiology*
  • Disease Models, Animal*
  • Drug Combinations
  • Drug Implants / administration & dosage
  • Drug-Eluting Stents / adverse effects*
  • Ezetimibe
  • Female
  • Graft Occlusion, Vascular / diagnosis
  • Graft Occlusion, Vascular / drug therapy*
  • Graft Occlusion, Vascular / etiology*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Simvastatin / administration & dosage*
  • Swine
  • Treatment Outcome

Substances

  • Anticholesteremic Agents
  • Azetidines
  • Drug Combinations
  • Drug Implants
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Simvastatin
  • Ezetimibe