International Circulation:  Drug-eluting stents can lead to endothelial dysfunction.  What is your opinion about that issue?

David Holmes:I think that is true， certainly.  I think it is uncommon.  There are some patients with whom it is clinically relevant.  The problem is that we see patients that have unusual symptoms following stent implantation.  Whether that is a result of endothelial dysfunction， which you can indeed document， or whether it is because the patients now have heightened awareness is unclear.  It certainly has been documented.  Whether that is the downstream effect of drug， the downstream effect of polymer， or the degradation process involving the polymer is a little hard to be sure.  All of the drug-eluting stent platforms look like they are going more towards biodegradable polymers， which are specific to prevent any inflammation， which has been documented.

 
D Holmes教授简介
 
Dr. David R. Holmes Jr.
Full Professor   University of Ottawa Ontario， Canada
David R. Holmes Jr.， M.D.， F.A.C.C.
ACC Vice President 2009-2010
Dr. Holmes is professor of medicine， Mayo Clinic College of Medicine and has Master’s Faculty  Privileges in Clinical Research at the Mayo Graduate School of Medicine， Rochester， Minn. He also serves as a consultant in cardiovascular medicine. An invasive and interventional cardiologist， Holmes is chair of upcoming i2 Summit 2009 in Orlando and has played a major  role in the development of all i2 Summit meetings. His professional experience and academic  appointments have included director of electrophysiology and pacing and director of the  cardiac catheterization laboratory， both at the Mayo Clinic. He has been active in many ACC  activities， including serving as a member of the ACC Board of Trustees. Holmes has received  numerous awards over the years， including the ACC Distinguished Scientist Award (Clinical  Domain) in 2004. He has published extensively and serves on the editorial boards of many  journals， including the Journal of the American College of Cardiology.