Different Vascular Healing Patterns With Various Drug-Eluting Stents in Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction: Optical Coherence Tomographic Findings - 05/08/11
, Jung Myung Lee, MD b, Tae Hoon Kim, MD b, Sang Min Park, MD b, Jin Wi, MD b, Sung Il Paik, RT b, Young-Guk Ko, MD b, Donghoon Choi, MD, PhD b, Myeong-Ki Hong, MD, PhD b, Yangsoo Jang, MD, PhD b
Corresponding author: Tel: (82) 2-2228-8460; fax: (82) 2-393-2041Résumé |
The introduction of optical coherence tomography has provided a new method for evaluating the vascular response to drug-eluting stents (DESs). We used optical coherence tomography to compare neointimal coverage and stent malapposition among DESs in patients with ST-segment elevation myocardial infarction. Optical coherence tomography was performed at 9 months after implantation of 3 types of DESs at the culprit lesions in 46 patients with ST-segment elevation myocardial infarction (16 sirolimus-eluting stents [SESs, Cypher Select], 11 paclitaxel-eluting stents [PESs, Taxus Liberte], and 19 zotarolimus-eluting stents [ZESs, Endeavor Sprint]). The neointimal thickness and apposition at each strut at each 1-mm interval and the presence of thrombi in each stent were evaluated. A total of 11,512 stent struts were analyzed. SESs had the thinnest neointimal thickness (SES 62 ± 43 μm vs PES 244 ± 142 μm vs ZES 271 ± 128 μm, p <0.001). The incidence of uncovered struts and malapposed struts were significantly greater in SESs and PESs than in ZESs (SES vs PES vs ZES, 16.2 ± 17.8% vs 4.7 ± 7.4% vs 0.6 ± 1.5%, respectively, p = 0.001; and 4.0 ± 8.2% vs 2.1 ± 4.5% vs 0 ± 0%, respectively, p = 0.001). Thrombus was also detected more often in SESs and PESs than in ZESs (SES, 6 [38%] vs PES, 3 [27%] vs ZES, 1 [5%], p = 0.02). In conclusion, the rate of stent strut coverage and malapposition were significantly different among the DES types in ST-segment elevation myocardial infarction. In particular, most stent struts in ZESs were covered with neointima and well-apposed. These findings imply that the type of DES might affect the vascular response in thrombotic lesions of ST-segment elevation myocardial infarction.
Le texte complet de cet article est disponible en PDF.Plan
| This study was partly supported by a grant from the Korea Health 21 R&D Project, Ministry of Health and Welfare, and Republic of Korea (grants A085012, A000385, A085136, and 0412-CR02-0704-0001), and the Cardiovascular Research Center, Seoul, Korea. |
Vol 105 - N° 7
P. 972-976 - avril 2010 Retour au numéro
Article précédent
- Comparison of Hospital Mortality With Intra-Aortic Balloon Counterpulsation Insertion Before Versus After Primary Percutaneous Coronary Intervention for Cardiogenic Shock Complicating Acute Myocardial Infarction
- Mohamed Abdel-Wahab, Mohammed Saad, Joerg Kynast, Volker Geist, Mohammad A. Sherif, Gert Richardt, Ralph Toelg
- Relation of Left Ventricular Ejection Fraction and Functional Capacity With Metabolism and Inflammation in Chronic Heart Failure With Reduced Ejection Fraction (from the MIMICA Study)
- Jorge Thierer, Adriana Acosta, Nora Vainstein, Mónica Sultan, Alejandra Francesia, Javier Marino, Alfredo Hirchson Prado, Ramiro Guglielmone, Marcelo Trivi, Laura Boero, Fernando Brites, Stefan Anker
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?