The Effects of Abciximab(ReoPro(r))-Coated Stents on Extracellular Matrix Synthesis and Apoptosis

ABSTRACT

BACKGROUND AND OBJECTIVES: The most important mechanism of coronary stent restenosis is neointimal hyperplasia (NIH). In addition to neointimal cell proliferation, synthesis of the extracellular matrix (ECM) may be important for the induction of NIH. The effects of the abciximab (ReoPro(r))-coated stent on the ECM synthesis and cellular apoptosis in coronary stent restenosis were observed. MATERIALS AND METHODS: Twenty one abciximab-coated stents and 21 control stents were placed in porcine coronary arteries and histopathologic analyses were performed at 14 days, 28 days and 56 days after the stenting procedures, respectively. Each specimen was analyzed by hematoxylin and eosin staining, modified Movat, immunohistochemical staining and TUNEL analysis. RESULTS: The area of neointima in the abciximab-coated stents was reduced by 45.7% and 45.5% of the control stents at 28 days and 56 days after stenting, respectively (1.9+/-0.5 vs. 3.5+/-0.7 mm2, 2.4+/-0.5 vs. 4.4+/-0.6 mm2, p=0.012, 0.001, respectively). The content ratio of the proteoglycan of the abciximab-coated stents was reduced by 23% at 14 days (12.4+/-4.4 vs. 16.1+/-4.3%, respectively, p=0.041) and the content ratio of collagen in the abciximab-coated stents was reduced by 19.7% and 25% at 28 days and 56 days, respectively (27.7+/-5.0 vs. 34.5+/-8.7%, 36.6+/-10.5 vs. 48.8+/-12.7%, p=0.021, 0.001, respectively). The proliferating cell nuclear antigen index of neointima for the abciximab-coated stents was reduced by 22.2% at 14 days (10.5+/-5.4 vs. 13.5+/-8.4%, respectively, p=0.022). There was no significant difference in the apoptosis, as was determined by TUNEL analysis between the two groups on the 56-day follow-up after stenting. CONCLUSION: The Abciximabcoated stent inhibits ECM synthesis, but it does not inhibit apoptosis in a porcine stent restenosis model.