1.The Effects of Nicotine on Re-endothelialization, Inflammation, and Neoatherosclerosis After Drug-Eluting Stent Implantation in a Porcine Model
Seok OH ; Ju Han KIM ; Saleem AHMAD ; Yu Jeong JIN ; Mi Hyang NA ; Munki KIM ; Jeong Ha KIM ; Dae Sung PARK ; Dae Young HYUN ; Kyung Hoon CHO ; Min Chul KIM ; Doo Sun SIM ; Young Joon HONG ; Seung-won LEE ; Youngkeun AHN ; Myung Ho JEONG
Korean Circulation Journal 2025;55(1):50-64
Background and Objectives:
Cigarette smoking is a major risk factor for atherosclerosis.Nicotine, a crucial constituent of tobacco, contributes to atherosclerosis development and progression. However, evidence of the association between nicotine and neointima formation is limited. We aimed to evaluate whether nicotine enhances neointimal hyperplasia in the native epicardial coronary arteries of pigs after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).
Methods:
After coronary angiography (CAG) and quantitative coronary angiography (QCA), we implanted 20 DES into 20 pigs allocated to 2 groups: no-nicotine (n=10) and nicotine (n=10) groups. Post-PCI CAG and QCA were performed immediately. Follow-up CAG, QCA, optical coherence tomography (OCT), and histopathological analyses were performed 2 months post-PCI.
Results:
Despite intergroup similarities in the baseline QCA findings, OCT analysis showed that the nicotine group had a smaller mean stent and lumen areas, a larger mean neointimal area, greater percent area stenosis, and higher peri-strut fibrin and inflammation scores than the no-nicotine group. In immunofluorescence analysis, the nicotine group displayed higher expression of CD68 and α-smooth muscle actin but lower CD31 expression than the no-nicotine group.
Conclusions
Nicotine inhibited re-endothelialization and promoted inflammation and NIH after PCI with DES in a porcine model.
2.The Effects of Nicotine on Re-endothelialization, Inflammation, and Neoatherosclerosis After Drug-Eluting Stent Implantation in a Porcine Model
Seok OH ; Ju Han KIM ; Saleem AHMAD ; Yu Jeong JIN ; Mi Hyang NA ; Munki KIM ; Jeong Ha KIM ; Dae Sung PARK ; Dae Young HYUN ; Kyung Hoon CHO ; Min Chul KIM ; Doo Sun SIM ; Young Joon HONG ; Seung-won LEE ; Youngkeun AHN ; Myung Ho JEONG
Korean Circulation Journal 2025;55(1):50-64
Background and Objectives:
Cigarette smoking is a major risk factor for atherosclerosis.Nicotine, a crucial constituent of tobacco, contributes to atherosclerosis development and progression. However, evidence of the association between nicotine and neointima formation is limited. We aimed to evaluate whether nicotine enhances neointimal hyperplasia in the native epicardial coronary arteries of pigs after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).
Methods:
After coronary angiography (CAG) and quantitative coronary angiography (QCA), we implanted 20 DES into 20 pigs allocated to 2 groups: no-nicotine (n=10) and nicotine (n=10) groups. Post-PCI CAG and QCA were performed immediately. Follow-up CAG, QCA, optical coherence tomography (OCT), and histopathological analyses were performed 2 months post-PCI.
Results:
Despite intergroup similarities in the baseline QCA findings, OCT analysis showed that the nicotine group had a smaller mean stent and lumen areas, a larger mean neointimal area, greater percent area stenosis, and higher peri-strut fibrin and inflammation scores than the no-nicotine group. In immunofluorescence analysis, the nicotine group displayed higher expression of CD68 and α-smooth muscle actin but lower CD31 expression than the no-nicotine group.
Conclusions
Nicotine inhibited re-endothelialization and promoted inflammation and NIH after PCI with DES in a porcine model.
3.Influence of self-efficacy in health management and resilience on treatment compliance in Korean patients undergoing percutaneous coronary intervention: a descriptive survey study
Mi-Ra JUNG ; Eun JEONG ; Kyung Sim LEE ; Jang Hyun CHO
Journal of Korean Biological Nursing Science 2025;27(2):266-274
This study aimed to identify factors influencing treatment compliance in Korean patients undergoing percutaneous coronary intervention. Methods: The study included 130 patients who underwent percutaneous coronary intervention at St. Carollo Hospital. Data were collected using self-administered questionnaires from March 21, 2022 to May 30, 2023, and analyzed using descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and multiple regression in SPSS version 26.0. Results: Resilience (β = .59, p < .001), alcohol drinking (β = −.18, p = .005), and the diagnosis (β = .13, p = .040) accounted for 45.0% of the variance in treatment compliance in patients undergoing percutaneous coronary intervention. Conclusion: These results indicate that it is necessary to explore strategies for developing and implementing programs that can effectively enhance resilience in patients who have undergone percutaneous coronary intervention.
4.Influence of self-efficacy in health management and resilience on treatment compliance in Korean patients undergoing percutaneous coronary intervention: a descriptive survey study
Mi-Ra JUNG ; Eun JEONG ; Kyung Sim LEE ; Jang Hyun CHO
Journal of Korean Biological Nursing Science 2025;27(2):266-274
This study aimed to identify factors influencing treatment compliance in Korean patients undergoing percutaneous coronary intervention. Methods: The study included 130 patients who underwent percutaneous coronary intervention at St. Carollo Hospital. Data were collected using self-administered questionnaires from March 21, 2022 to May 30, 2023, and analyzed using descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and multiple regression in SPSS version 26.0. Results: Resilience (β = .59, p < .001), alcohol drinking (β = −.18, p = .005), and the diagnosis (β = .13, p = .040) accounted for 45.0% of the variance in treatment compliance in patients undergoing percutaneous coronary intervention. Conclusion: These results indicate that it is necessary to explore strategies for developing and implementing programs that can effectively enhance resilience in patients who have undergone percutaneous coronary intervention.
5.Influence of self-efficacy in health management and resilience on treatment compliance in Korean patients undergoing percutaneous coronary intervention: a descriptive survey study
Mi-Ra JUNG ; Eun JEONG ; Kyung Sim LEE ; Jang Hyun CHO
Journal of Korean Biological Nursing Science 2025;27(2):266-274
This study aimed to identify factors influencing treatment compliance in Korean patients undergoing percutaneous coronary intervention. Methods: The study included 130 patients who underwent percutaneous coronary intervention at St. Carollo Hospital. Data were collected using self-administered questionnaires from March 21, 2022 to May 30, 2023, and analyzed using descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and multiple regression in SPSS version 26.0. Results: Resilience (β = .59, p < .001), alcohol drinking (β = −.18, p = .005), and the diagnosis (β = .13, p = .040) accounted for 45.0% of the variance in treatment compliance in patients undergoing percutaneous coronary intervention. Conclusion: These results indicate that it is necessary to explore strategies for developing and implementing programs that can effectively enhance resilience in patients who have undergone percutaneous coronary intervention.
6.The Effects of Nicotine on Re-endothelialization, Inflammation, and Neoatherosclerosis After Drug-Eluting Stent Implantation in a Porcine Model
Seok OH ; Ju Han KIM ; Saleem AHMAD ; Yu Jeong JIN ; Mi Hyang NA ; Munki KIM ; Jeong Ha KIM ; Dae Sung PARK ; Dae Young HYUN ; Kyung Hoon CHO ; Min Chul KIM ; Doo Sun SIM ; Young Joon HONG ; Seung-won LEE ; Youngkeun AHN ; Myung Ho JEONG
Korean Circulation Journal 2025;55(1):50-64
Background and Objectives:
Cigarette smoking is a major risk factor for atherosclerosis.Nicotine, a crucial constituent of tobacco, contributes to atherosclerosis development and progression. However, evidence of the association between nicotine and neointima formation is limited. We aimed to evaluate whether nicotine enhances neointimal hyperplasia in the native epicardial coronary arteries of pigs after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).
Methods:
After coronary angiography (CAG) and quantitative coronary angiography (QCA), we implanted 20 DES into 20 pigs allocated to 2 groups: no-nicotine (n=10) and nicotine (n=10) groups. Post-PCI CAG and QCA were performed immediately. Follow-up CAG, QCA, optical coherence tomography (OCT), and histopathological analyses were performed 2 months post-PCI.
Results:
Despite intergroup similarities in the baseline QCA findings, OCT analysis showed that the nicotine group had a smaller mean stent and lumen areas, a larger mean neointimal area, greater percent area stenosis, and higher peri-strut fibrin and inflammation scores than the no-nicotine group. In immunofluorescence analysis, the nicotine group displayed higher expression of CD68 and α-smooth muscle actin but lower CD31 expression than the no-nicotine group.
Conclusions
Nicotine inhibited re-endothelialization and promoted inflammation and NIH after PCI with DES in a porcine model.
7.Influence of self-efficacy in health management and resilience on treatment compliance in Korean patients undergoing percutaneous coronary intervention: a descriptive survey study
Mi-Ra JUNG ; Eun JEONG ; Kyung Sim LEE ; Jang Hyun CHO
Journal of Korean Biological Nursing Science 2025;27(2):266-274
This study aimed to identify factors influencing treatment compliance in Korean patients undergoing percutaneous coronary intervention. Methods: The study included 130 patients who underwent percutaneous coronary intervention at St. Carollo Hospital. Data were collected using self-administered questionnaires from March 21, 2022 to May 30, 2023, and analyzed using descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and multiple regression in SPSS version 26.0. Results: Resilience (β = .59, p < .001), alcohol drinking (β = −.18, p = .005), and the diagnosis (β = .13, p = .040) accounted for 45.0% of the variance in treatment compliance in patients undergoing percutaneous coronary intervention. Conclusion: These results indicate that it is necessary to explore strategies for developing and implementing programs that can effectively enhance resilience in patients who have undergone percutaneous coronary intervention.
8.The Effects of Nicotine on Re-endothelialization, Inflammation, and Neoatherosclerosis After Drug-Eluting Stent Implantation in a Porcine Model
Seok OH ; Ju Han KIM ; Saleem AHMAD ; Yu Jeong JIN ; Mi Hyang NA ; Munki KIM ; Jeong Ha KIM ; Dae Sung PARK ; Dae Young HYUN ; Kyung Hoon CHO ; Min Chul KIM ; Doo Sun SIM ; Young Joon HONG ; Seung-won LEE ; Youngkeun AHN ; Myung Ho JEONG
Korean Circulation Journal 2025;55(1):50-64
Background and Objectives:
Cigarette smoking is a major risk factor for atherosclerosis.Nicotine, a crucial constituent of tobacco, contributes to atherosclerosis development and progression. However, evidence of the association between nicotine and neointima formation is limited. We aimed to evaluate whether nicotine enhances neointimal hyperplasia in the native epicardial coronary arteries of pigs after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).
Methods:
After coronary angiography (CAG) and quantitative coronary angiography (QCA), we implanted 20 DES into 20 pigs allocated to 2 groups: no-nicotine (n=10) and nicotine (n=10) groups. Post-PCI CAG and QCA were performed immediately. Follow-up CAG, QCA, optical coherence tomography (OCT), and histopathological analyses were performed 2 months post-PCI.
Results:
Despite intergroup similarities in the baseline QCA findings, OCT analysis showed that the nicotine group had a smaller mean stent and lumen areas, a larger mean neointimal area, greater percent area stenosis, and higher peri-strut fibrin and inflammation scores than the no-nicotine group. In immunofluorescence analysis, the nicotine group displayed higher expression of CD68 and α-smooth muscle actin but lower CD31 expression than the no-nicotine group.
Conclusions
Nicotine inhibited re-endothelialization and promoted inflammation and NIH after PCI with DES in a porcine model.
9.Preliminary Investigation on Efficacy and Safety of Substance P-Coated Stent for Promoting Re-Endothelialization: A Porcine Coronary Artery Restenosis Model
Dae Sung PARK ; Seok OH ; Yu Jeong JIN ; Mi Hyang NA ; Munki KIM ; Jeong Ha KIM ; Dae Young HYUN ; Kyung Hoon CHO ; Young Joon HONG ; Ju Han KIM ; Youngkeun AHN ; Manuel HERMIDA-PRIETO ; José Manuel VÁZQUEZ-RODRIGUEZ ; Juan Luis GUTIÉRREZ- CHICO ; Luis MARINÃS-PARDO ; Kyung Seob LIM ; Jun-Kyu PARK ; Dae-Heung BYEON ; Young-Nan CHO ; Seung-Jung KEE ; Doo Sun SIM ; Myung Ho JEONG
Tissue Engineering and Regenerative Medicine 2024;21(1):53-64
BACKGROUND:
Current polymer-based drug-eluting stents (DESs) have fundamental issues about inflammation and delayed re-endothelializaton of the vessel wall. Substance-P (SP), which plays an important role in inflammation and endothelial cells, has not yet been applied to coronary stents. Therefore, this study compares poly lactic-co-glycolic acid (PLGA)-based everolimus-eluting stents (PLGA-EESs) versus 2-methacryloyloxyethyl phosphorylcholine (MPC)-based SP-eluting stents (MPC-SPs) in in-vitro and in-vivo models.
METHODS:
The morphology of the stent surface and peptide/drug release kinetics from stents were evaluated. The invitro proliferative effect of SP released from MPC-SP is evaluated using human umbilical vein endothelial cell. Finally, the safety and efficacy of the stent are evaluated after inserting it into a pig’s coronary artery.
RESULTS:
Similar to PLGA-EES, MPC-SP had a uniform surface morphology with very thin coating layer thickness (2.074 lm). MPC-SP showed sustained drug release of SP for over 2 weeks. Endothelial cell proliferation was significantly increased in groups treated with SP (n = 3) compared with the control (n = 3) and those with everolimus (n = 3) (SP:118.9 ± 7.61% vs. everolimus: 64.3 ± 12.37% vs. the control: 100 ± 6.64%, p < 0.05). In the animal study, the percent stenosis was higher in MPC-SP group (n = 7) compared to PLGA-EES group (n = 7) (MPC-SP: 28.6 ± 10.7% vs. PLGAEES: 16.7 ± 6.3%, p < 0.05). MPC-SP group showed, however, lower inflammation (MPC-SP: 0.3 ± 0.26 vs. PLGAEES: 1.2 ± 0.48, p < 0.05) and fibrin deposition (MPC-SP: 1.0 ± 0.73 vs. PLGA-EES: 1.5 ± 0.59, p < 0.05) around the stent strut. MPC-SP showed more increased expression of cluster of differentiation 31, suggesting enhanced reendothelialization.
CONCLUSION
Compared to PLGA-EES, MPC-SP demonstrated more decreased inflammation of the vascular wall and enhanced re-endothelialization and stent coverage. Hence, MPC-SP has the potential therapeutic benefits for the treatment of coronary artery disease by solving limitations of currently available DESs.
10.Efficacy and Safety Evaluation of Tacrolimus-Eluting Stent in a Porcine Coronary Artery Model
Dae Sung PARK ; Mi Hyang NA ; Myung Ho JEONG ; Doo Sun SIM ; Yu Jeong JIN ; Hae Jin KEE ; Mun Ki KIM ; Jeong Ha KIM ; Young Joon HONG ; Kyung Hoon CHO ; Dae Young HYUN ; Seok OH ; Kyung Seob LIM ; Dae-Heung BYEON ; Jeong Hun KIM
Tissue Engineering and Regenerative Medicine 2024;21(5):723-735
BACKGROUND:
A drug-eluting stent (DES) is a highly beneficial medical device used to widen or unblock narrowed blood vessels. However, the drugs released by the implantation of DES may hinder the re-endothelialization process, increasing the risk of late thrombosis. We have developed a tacrolimus-eluting stent (TES) that as acts as a potent antiproliferative and immunosuppressive agent, enhancing endothelial regeneration. In addition, we assessed the safety and efficacy of TES through both in vitro and in vivo tests.
METHODS:
Tacrolimus and Poly(lactic-co-glycolic acid) (PLGA) were applied to the metal stent using electrospinning equipment. The surface morphology of the stent was examined before and after coating using a scanning electron microscope (SEM) and energy dispersive X-rays (EDX). The drug release test was conducted through high-performance liquid chromatography (HPLC). Cell proliferation and migration assays were performed using smooth muscle cells (SMC).The stent was then inserted into the porcine coronary artery and monitored for a duration of 4 weeks.
RESULTS:
SEM analysis confirmed that the coating surface was uniform. Furthermore, EDX analysis showed that the surface was coated with both polymer and drug components. The HPCL analysis of TCL at a wavelength of 215 nm revealed that the drug was continuously released over a period of 4 weeks. Smooth muscle cell migration was significantly decreased in the tacrolimus group (54.1% ± 11.90%) compared to the non-treated group (90.1% ± 4.86%). In animal experiments, the stenosis rate was significantly reduced in the TES group (29.6% ± 7.93%) compared to the bare metal stent group (41.3% ± 10.18%). Additionally, the fibrin score was found to be lower in the TES group compared to the group treated with a sirolimus-eluting stent (SES).
CONCLUSION
Similar to SES, TES reduces neointimal proliferation in a porcine coronary artery model, specifically decreasing the fibrins score. Therefore, tacrolimus could be considered a promising drug for reducing restenosis and thrombosis.

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