Early-Phase Vascular Healing of Bioabsorbable vs. Durable Polymer-Coated Everolimus-Eluting Stents in Patients With ST-Elevation Myocardial Infarction - 2-Week and 4-Month Analyses With Optical Coherence Tomography

Circ J. 2018 Sep 25;82(10):2594-2601. doi: 10.1253/circj.CJ-18-0230. Epub 2018 Jul 11.

Abstract

Background: Despite the revolution of coronary stents, there remain concerns about the risk of stent thrombosis, especially in patients with ST-elevation myocardial infarction (STEMI). The present study compared early vascular healing as a contributing factor to reducing stent thrombosis between Xience everolimus-eluting stents (X-EES) and Synergy everolimus-eluting stents (S-EES) in patients with STEMI.

Methods and results: The present study included 47 patients with STEMI requiring primary percutaneous coronary intervention with X-EES (n=25) or S-EES (n=22). Optical coherence tomography (OCT) assessments of the stented lesions were performed 2 weeks and 4 months after stent implantation. Neointimal strut coverage, malapposition and the frequency of thrombus formation were evaluated. In the 2-week OCT analysis, the proportion of covered struts in S-EES (42.4±15.4%) was significantly higher than in X-EES (26.3±10.1%, P<0.001). In the 4-month OCT analysis, the proportion of covered struts in S-EES (72.2±17.9%) was still significantly higher than in X-EES (62.0±14.9%, P=0.04).

Conclusions: Compared with X-EES, S-EES showed a higher proportion of covered struts in the early phase after stent implantation for STEMI patients.

Keywords: Neointimal coverage; Stent thrombosis; Vascular healing.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Coronary Vessels / surgery
  • Drug-Eluting Stents / adverse effects
  • Drug-Eluting Stents / standards*
  • Everolimus / administration & dosage
  • Everolimus / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neointima / diagnostic imaging
  • ST Elevation Myocardial Infarction / therapy
  • Thrombosis / etiology*
  • Thrombosis / prevention & control
  • Tomography, Optical Coherence
  • Wound Healing / drug effects

Substances

  • Everolimus