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Different vascular healing patterns with various drug-eluting stents in primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: optical coherence tomographic findings

Authors
 Chunyu Fan  ;  Jung-Sun Kim  ;  Jung Myung Lee  ;  Tae Hoon Kim  ;  Sang Min Park  ;  Jin Wi  ;  Sung Il Paik  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Myeong-Ki Hong  ;  Yangsoo Jang 
Citation
 AMERICAN JOURNAL OF CARDIOLOGY, Vol.105(7) : 972-976, 2010 
Journal Title
 AMERICAN JOURNAL OF CARDIOLOGY 
ISSN
 0002-9149 
Issue Date
2010
MeSH
Angioplasty, Balloon, Coronary* ; Drug-Eluting Stents* ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/physiopathology ; Myocardial Infarction/therapy* ; Tomography, Optical Coherence* ; Treatment Outcome ; Wound Healing
Abstract
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 mum vs PES 244 +/- 142 mum vs ZES 271 +/- 128 mum, 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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0002914909027325
DOI
10.1016/j.amjcard.2009.11.018
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Park, Sang Min(박상민)
Wi, Jin(위진) ORCID logo https://orcid.org/0000-0003-0655-5130
Lee, Jung Myung(이정명)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100777
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