Does "late catch-up" exist in drug-eluting stents: insights from a serial quantitative coronary angiography analysis of sirolimus versus paclitaxel-eluting stents.
BACKGROUND
Recent studies have suggested the possibility of late catch-up after drug-eluting stent implantation. There are limited data on whether late catch-up exists in sirolimus-eluting stents (SESs) and paclitaxel-eluting stents (PESs).


METHODS
Consecutive patients were routinely recommended 2 serial angiographic follow-ups (at 6-9 and 18-24 months post-percutaneous coronary intervention). A serial quantitative coronary angiographic analysis was performed in lesions not receiving target lesion revascularization at first follow-up. Early luminal loss (LL) was defined as the difference in minimal luminal diameter between the first angiographic follow-up and immediate post-percutaneous coronary intervention, and delayed LL was defined as the difference in minimal luminal diameter between the second and first angiographic follow-up.


RESULTS
Four hundred twelve lesions in the main cohort (PES 128, SES 284) and 47 lesions in the secondary hybrid cohort (PES 23, SES 24), which received serial angiographic follow-ups without target lesion revascularization, were included. In the main cohort, early LL was higher in PES compared with SES (0.56 vs 0.20 mm, P < .01), whereas delayed LL occurring after the first angiographic follow-up was higher in SES (0.10 vs 0.28 mm, P < .01), suggesting more prominent late catch-up in SES. Early LL showed better correlation with total LL (correlation coefficient 0.82 vs 0.30) in PES, whereas delayed LL showed better correlation with total LL (correlation coefficient 0.42 vs 0.91) in SES. Such observations were reproducible in the hybrid cohort, where both SES and PES were implanted at index procedure.


CONCLUSIONS
Late catch-up occurs in both PES and SES with greater delayed late loss in SES. Our data suggest that the process of neointima formation after SES and PES implantation may follow a slightly different timeline.
Park
Kyung Woo
KW
Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea.
Kim
Chi-Hoon
CH
Lee
Hae-Young
HY
Kang
Hyun-Jae
HJ
Koo
Bon-Kwon
BK
Oh
Byung-Hee
BH
Park
Young-Bae
YB
Kim
Hyo-Soo
HS
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D017023:Coronary Angiography; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D020123:Sirolimus / Q000008:administration & dosage*; D013997:Time Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology
D017239:Paclitaxel; D020123:Sirolimus