Coronary Endothelial Dysfunction after Drug-Eluting Stent Implantation

Abstract

Problem statement: Stent thrombosis, which may occur even one year after stent implantation, is a drawback of Drug-Eluting Stents (DES). Among the variety of causes of stent thrombosis after DES implantation, coronary endothelial dysfunction manifested or exaggerated by DES implantation should not be overlooked. This review article summarizes previous reports on coronary endothelial dysfunction after DES implantation and/or coronary spasm and discusses the mechanism, clinical implications and prognosis. Although novel stents that do not impair endothelial function will most likely be developed in the near future, millions of patients have already undergone implantation of a first or second generation DES. Conclusion/Recommendations: Some studies have reported that a drug improves the impairment of endothelial function. On the other hand, no direct relationships between spasm and stent thrombosis after DES implantation have been reported. A larger study is warranted to clarify the clinical significance of this important clinical issue.