Coronary vasomotion was evaluated with quantitative coronary angiography at rest and during supine bicycle exercise in nine patients with EES and thirteen patients with BES, 16 months after stent implantation. Mean luminal diameter of the stent, peristent segments, and of a control vessel were determined at rest, during exercise, and after the administration of nitroglycerine.
The control vessel showed exercise-induced vasodilatation in both groups (EES: + 6.4 ± 5.5%, p = 0.07; BES: + 7.8 ± 10.1%, p = 0.07). Vasomotion in the stented vessel segment was abolished. There was exercise-induced vasoconstriction in both groups in the segments proximal (EES: − 9.6 ± 4.5%; p = 0.03; BES: − 4.3 ± 5.4%, p = 0.02) and distal to the stent (EES: − 3.2 ± 9.3%; p = 0.41, BES − 8.6 ± 8.0%, p < 0.01). Sublingual nitroglycerin was associated with maximal vasodilatation of the peristent segments in both groups.
Alike DES with durable polymer, stents with a biodegradable polymer are associated with exercise-induced paradoxical coronary vasoconstriction of the peristent segments. This data suggests that endothelial dysfunction after DES implantation is not primarily caused by the durability of the polymer coating.