Tissue Sirolimus Levels of Distal Vessel, Stented Myocardium, and Distal Myocardium
Hideaki Kaneda, MD, PhD,
Alan Yeung, MD,
Fumiaki Ikeno, MD*
With great interest we read the article by Li et al. (1) regarding vasomotor functional responses of a conduit coronary artery distal to sirolimus-eluting stents in a porcine model. The researchers stated in the discussion, "...most of the drug taken up into cardiac tissue was transferred by direct contact with the arterial wall, which may have served as a reservoir for subsequent transfer via diffusion, or the vasa vasorum" (1). However, we have previously reported that tissue sirolimus levels of proximal/distal vessel, stented myocardium, and proximal/distal myocardium were much lower (less than 2%) than the stented vessel area concentration (peaked at 1 day after stent implantation [14.5 ± 10.9 ng/ml]). Moreover, sirolimus was not detected in either the proximal or distal myocardium at 30 days (2). Therefore, even low sirolimus concentrations with short duration may affect vasomotor function.
* Division of Cardiology, Stanford University, 300 Pasteur Drive, FALK CVRB, Stanford, California 94305 (Email: fikeno{at}stanford.edu).
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REFERENCES
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- Li J, Jabara R, Pendyala R, et al. Abnormal vasomotor function of porcine coronary arteries distal to sirolimus-eluting stents J Am Coll Cardiol Intv 2008;1:279-285.[Abstract/Free Full Text]
- Ikeno F, Bailey L, Willard C, Kopia GA, Tio F, Dooley J. Sirolimus-eluting stents: pharmacokinetics in blood, vessel, and myocardium in a porcine coronary model J Am Coll Cardiol 2004;43:A83(abstr).
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