This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: j.jacc.2005.09.047v1 47/4/708    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wessely, R. Articles by Kastrati, A. Search for Related Content PubMed PubMed Citation Articles by Wessely, R. Articles by Kastrati, A.

VIEWPOINT

Sirolimus and Paclitaxel on Polymer-Based Drug-Eluting Stents

Similar But Different

Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, University of Technology, Munich, Germany.

Manuscript received July 15, 2005; revised manuscript received September 17, 2005, accepted September 26, 2005.

^_* Reprint requests and correspondence: Dr. Rainer Wessely, Deutsches Herzzentrum, Lazarettstr. 36, 80636 Munich, Germany. (Email: rwessely{at}dhm.mhn.de).

Recent clinical studies that investigated the efficacy of the two U.S. Food and Drug Administration-approved drug-eluting stent (DES) platforms Cypher (Cordis, Johnson and Johnson, Miami Lakes, Florida) and Taxus (Boston Scientific, Boston, Massachusetts) suggest that there are differences between both DES concerning neointimal growth. Both DES elute compounds that inhibit the cell cycle, but at different stages: Cypher stents elute sirolimus, which induces G₁ cell cycle inhibition, and Taxus stents release paclitaxel, which predominantly leads to M-phase arrest. In an attempt to explain the differences observed in human studies, the properties of these stent-based compounds on critical molecular and cellular events associated with the pathophysiology of in-stent restenosis are discussed in detail with the conclusion that both sirolimus and paclitaxel are different in their pleiotropic anti-restenotic effects. This may be in part responsible for the differences observed in recent clinical studies.

Abbreviations and Acronyms   CKI = cyclin-dependent kinase inhibitor   DES = drug-eluting stent   mTOR = mammalian target of rapamycin   PTX = paclitaxel   SRL = sirolimus   TLR = target lesion revascularization   VSMC = vascular smooth muscle cell

This article has been cited by other articles:

				S.-i. Hayashi, A. Yamamoto, F. You, K. Yamashita, Y. Ikegame, M. Tawada, T. Yoshimori, S. Shimizu, and S. Nakashima The Stent-Eluting Drugs Sirolimus and Paclitaxel Suppress Healing of the Endothelium by Induction of Autophagy Am. J. Pathol., November 1, 2009; 175(5): 2226 - 2234. [Abstract] [Full Text] [PDF]

				R A Byrne, S Kufner, K Tiroch, S Massberg, K-L Laugwitz, A Birkmeier, S Schulz, J Mehilli, and for the Intracoronary Stenting and Angiographic Re Randomised trial of three rapamycin-eluting stents with different coating strategies for the reduction of coronary restenosis: 2-year follow-up results Heart, September 15, 2009; 95(18): 1489 - 1494. [Abstract] [Full Text] [PDF]

				A. Kaltoft, L. O. Jensen, M. Maeng, H. H. Tilsted, P. Thayssen, M. Bottcher, J. F. Lassen, L. R. Krusell, K. Rasmussen, K. N. Hansen, et al. 2-Year Clinical Outcomes After Implantation of Sirolimus-Eluting, Paclitaxel-Eluting, and Bare-Metal Coronary Stents Results From the WDHR (Western Denmark Heart Registry). J. Am. Coll. Cardiol., February 24, 2009; 53(8): 658 - 664. [Abstract] [Full Text] [PDF]

				J. Mehilli, R. A. Byrne, A. Wieczorek, R. Iijima, S. Schulz, O. Bruskina, J. Pache, R. Wessely, A. Schomig, A. Kastrati, et al. Randomized trial of three rapamycin-eluting stents with different coating strategies for the reduction of coronary restenosis Eur. Heart J., August 2, 2008; 29(16): 1975 - 1982. [Abstract] [Full Text] [PDF]

				E. Mahmud, G. Bromberg-Marin, V. Palakodeti, L. Ang, D. Creanga, and A. N. DeMaria Clinical efficacy of drug-eluting stents in diabetic patients: a meta-analysis. J. Am. Coll. Cardiol., June 24, 2008; 51(25): 2385 - 2395. [Abstract] [Full Text] [PDF]

				R. Wessely, A. Kastrati, J. Mehilli, A. Dibra, J. Pache, and A. Schomig Randomized trial of rapamycin- and paclitaxel-eluting stents with identical biodegradable polymeric coating and design Eur. Heart J., November 2, 2007; 28(22): 2720 - 2725. [Abstract] [Full Text] [PDF]

				T. Adriaenssens, J. Mehilli, R. Wessely, G. Ndrepepa, M. Seyfarth, A. Wieczorek, B. Blaich, R. Iijima, J. Pache, A. Kastrati, et al. Does Addition of Estradiol Improve the Efficacy of a Rapamycin-Eluting Stent?: Results of the ISAR-PEACE Randomized Trial J. Am. Coll. Cardiol., March 27, 2007; 49(12): 1265 - 1271. [Abstract] [Full Text] [PDF]

				A. N. DeMaria, O. Ben-Yehuda, G. K. Feld, G. S. Ginsburg, B. H. Greenberg, W. Y.W. Lew, J. A.C. Lima, A. S. Maisel, J. Narula, D. J. Sahn, et al. Highlights of the Year in JACC 2006 J. Am. Coll. Cardiol., January 30, 2007; 49(4): 509 - 527. [Full Text] [PDF]

				S. Tsimikas Drug-Eluting Stents and Late Adverse Clinical Outcomes: Lessons Learned, Lessons Awaited J. Am. Coll. Cardiol., May 16, 2006; 47(10): 2112 - 2115. [Full Text] [PDF]