Document Detail


Different vascular healing patterns with various drug-eluting stents in primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: optical coherence tomographic findings.
MedLine Citation:
PMID:  20346315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
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
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-02-13
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-29     Completed Date:  2010-04-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  972-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Division of Cardiology, First Hospital, ShanXi Medical University, Taiyuan, China.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary*
Drug-Eluting Stents*
Female
Humans
Male
Middle Aged
Myocardial Infarction / physiopathology,  therapy*
Tomography, Optical Coherence*
Treatment Outcome
Wound Healing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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