Different Vascular Healing Patterns With Various Drug-Eluting Stents in Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction: Optical Coherence Tomographic Findings

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

Research output: Contribution to journalArticle

19 Citations (Scopus)

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 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.

Original languageEnglish
Pages (from-to)972-976
Number of pages5
JournalAmerican Journal of Cardiology
Volume105
Issue number7
DOIs
Publication statusPublished - 2010 Apr 1

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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