Late stent strut apposition and coverage after drug-eluting stent implantation by optical coherence tomography in patients with acute myocardial infarction.
Cheol Hyun Lee, Seonhwa Lee, Jongmin Hwang, In-Cheol Kim, Yun-Kyeong Cho, Hyuck-Jun Yoon, Hyungseop Kim, Chang-Wook Nam, Seung-Ho Hur
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引用次数: 0
Abstract
Background: Although drug-eluting stents (DES) are effective, stent thrombosis (ST) remains a major concern in patients with acute myocardial infarction (AMI) who undergo DES implantation. We aimed to evaluate the incidence of late stent malapposition (SM) and uncovered struts 12 months after implantation of a bioabsorbable polymer everolimus-eluting stent (BP-EES) or a durable polymer zotarolimus-eluting stent (DP-ZES) in patients with AMI using optical coherence tomography (OCT).
Methods: Sixty-nine patients with AMI were randomly assigned 2:1 to the BP-EES (46 patients) or DP-ZES (23 patients) groups. The coprimary endpoints were the incidences of late SM and uncovered stent struts in OCT strut-level analysis at 12 months postimplantation.
Results: The 51 patients who completed the 12-month follow-up OCT (BP-EES, 36 patients, 39 lesions; DP-ZES, 15 patients, 18 lesions) showed no intergroup differences in the incidence of acute SM (BP-EES vs. DP-ZES; 12.25 ± 14.27% vs. 12.35 ± 10.55%, P = 0.981) at the index procedure. The incidence of late SM (0.12 ± 0.42% vs. 0.14 ± 0.25%, P = 0.873) and uncovered struts (1.69 ± 3.44% vs. 2.45 ± 3.23%, P = 0.532) also did not differ between the two DES groups at 12-month postimplantation.
Conclusion: Twelve-month OCT measurements showed no significant differences in late SM and uncovered struts between the BP-EES and DP-ZES stents. Thus, contemporary second-generation DES show a very low rate of late SM and uncovered struts after 12 months in AMI, regardless of stent polymer type.
Trial registration: Late stent strut apposition and coverage after drug-eluting stent implantation by OCT in patients with AMI (APPOSITION AMI-II) (NCT02770651).
期刊介绍：
Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management.
Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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