Two-Year Follow-Up of the Quantitative Angiographic and Volumetric Intravascular Ultrasound Analysis After Nonpolymeric Paclitaxel-Eluting Stent Implantation. Late "Catch-Up" Phenomenon From ASPECT Study

Duk Woo Park, Myeong Ki Hong, Gary S. Mintz, Cheol Whan Lee, Jong Min Song, Ki Hoon Han, Duk Hyun Kang, Sang Sig Cheong, Jae Kwan Song, Jae Joong Kim, Neil J. Weissman, Seong Wook Park, Seung Jung Park

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

Objectives: This study used serial angiographic and intravascular ultrasound (IVUS) analysis to evaluate the long-term efficacy of a nonpolymeric, paclitaxel-eluting stent coating on intimal hyperplasia (IH) 2 years after implantation. Background: Long-term efficacy of patients treated with nonpolymeric paclitaxel-eluting stents beyond 1 year has not been well determined. Methods: Patients were randomized to placebo or 1 of 2 doses of paclitaxel (low dose, 1.28 μg/mm2; high dose, 3.10 μg/mm2). Complete after-procedure, 6-month, and 2-year angiographic and IVUS data were available in 53 patients (17, 17, and 19 patients, respectively). Results: Baseline characteristics were similar among the 3 groups. Although 6-month minimal luminal diameter (MLD) was significantly smaller in placebo compared with paclitaxel-eluting stent patients (1.9 ± 0.6 mm in placebo, 2.5 ± 0.6 mm in low-dose, and 2.6 ± 0.5 mm in high-dose patients, p = 0.004), the MLDs at 2 years were similar (2.3 ± 0.6 mm, 2.3 ± 0.7 mm, and 2.0 ± 0.8 mm, respectively, p = 0.4). Despite a stepwise reduction in IH accumulation at 6 months (23 ± 18 mm3 in placebo, 14 ± 11 mm3 in low-dose, and 10 ± 12 mm3 in high-dose, p = 0.017), the increase of IH volume from 6 months to 2 years was significantly greater in the high-dose patients (13 ± 14 mm3 in high-dose vs. 4 ± 7 mm3 in low-dose patients, p = 0.074; and vs. 1 ± 13 mm3 in placebo, p = 0.019). Late target lesion revascularization (beyond 1 year) was performed in 2 high-dose patients. Conclusions: Despite the suppression of IH after non-polymeric paclitaxel-eluting stents compared with bare-metal stents at 6 months, a "late catch-up" IH growth was found in the high-dose patients at 2-year follow-up.

Original languageEnglish
Pages (from-to)2432-2439
Number of pages8
JournalJournal of the American College of Cardiology
Volume48
Issue number12
DOIs
Publication statusPublished - 2006 Dec 19

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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