Tuesday, May 03, 2011


I came across this rather interesting paper by Dr Jim Kleinedler of the Louisiana State University Health Science Center, presented at the just concluded American Heart Association Arteriosclerosis, Thrombosis and Vascular Biology 2011 Annual Scientific Meeting at Chicago.
The paper is entitled " Red wine polyphenol-eluting stent reduces neointimal hyperplasia and promotes re-endothelialization in a rat model of stenting angioplasty". They studied rat carotid models with polyphenol eluting stents implanted. They showed that in these rat models, the polyphenol eluting stents did reduce restenosis, and also accelerated re-endothelialisation. This is ideal.
At the moment, our drug eluting stents are coated with drugs that either kill cells that cause restenosis, the process of neo-intimal hyperplasia, or actively inhibit them. By so doing, they reuce intimal hyperplasia, and so re-stenosis, but also leave the stent with delayed healing, thereby making it prone to stent thrombosis. We need the endothelial cells to protect the stent against thrombosis, but we do not need too much intimal hyperplasia to promote restenosis. Therefore, if an agent could come by, that can inhibit intimal hyperplasia, and yet promote re-endothelialisation, that would be ideal.
The active polyphenols in red wine are the " resveratrol and quercetin. The resveratrol part will reduce neointimal hyperplasia, reduce inflammation and promote re-endothelialisation, and the quercetin part will reduce platelet activation, reduce smooth muscle proliferation and also act as an anti-oxidant.
When they implanted the polyphenol stents in the rat carotids, they compared 4 groupd. The group with a low dose polyphenols, the group with high dose polyphenols, the group with bare metal stents and the group without any stents. The results show that both the polyphenol groups did better than the other two groups, in terms of restenosis and stent thrombosis.
What a novel idea. I suppose we should watch this page, for more developments. Sometimes what works in rats may not do well with humans.
It is also interesting to extend the hypothesis, to include drinking red wine to see if it affects restenosis of DES? Can we reduce the need of 1 year of dual anti-platelet therapy ( 1 year of chlopidogrel can be costly ), in those who consume red wine in moderation? Interesting. Some of us drink a bit of red wine and this could be a nice benefit. We all know that red wine helps the heart. This may also give a boost to the growing wine market.
I will surely watch this page to see how the work develops. For the moment, it will still be limus-eluting stents, and a glass of red wine. At worse, it does no harm. Cheers

No comments: