Color of culprit lesion at 6 months after plain old balloon angioplasty versus stenting in patients with acute myocardial infarction.
BACKGROUND
Although the healing process of disrupted yellow plaques at myocardial infarction (MI) culprit lesions has been reported, the effect of stenting on this process has not been clarified. Stenting has been reported to deteriorate the endothelial function after percutaneous coronary intervention (PCI). Therefore, we compared the angioscopic morphology of culprit lesions at 6 months after plain old balloon angioplasty (POBA) and stenting to clarify the effect of stenting on the healing of disrupted culprit plaques of acute MI.


METHODS
Patients with acute MI who had yellow culprit plaque, successful reperfusion therapy with POBA (n = 21) or stenting (n = 22), and a successful 6-month follow-up angioscopic examination were included in this study. Oral ticlopidine (200 mg/day) was administered for 3 to 6 months after stenting.


RESULTS
At 6 months after reperfusion therapy, the color of the culprit lesion became white in significantly more patients treated with stenting than treated with POBA (50% vs 14%; P = .01). However, the prevalence of thrombus appeared to be higher in patients treated with stenting than in patients treated with POBA (27% vs 5%; P = .04). Although there was some difference in the patients' characteristics in the groups, logistic regression analysis revealed no significant influence of those factors on the color of or on the prevalence of thrombus at the culprit lesion.


CONCLUSIONS
Coronary stenting in patients with acute MI leads to the disappearance of yellow color at a significantly higher rate than POBA; however, whether it stabilizes the plaque requires further investigation.
Ueda
Yasunori
Y
Cardiovascular Division, Osaka Police Hospital, Osaka, Japan. ueda@oph.gr.jp
Ohtani
Tomohito
T
Shimizu
Masahiko
M
Mizote
Isamu
I
Ohyabu
Jota
J
Hirayama
Atsushi
A
Kodama
Kazuhisa
K
D015906:Angioplasty, Balloon, Coronary; D003116:Color; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D015607:Stents