Comparison of the effect of preinterventional arterial remodeling on intimal hyperplasia after implantation of a sirolimus- or paclitaxel-eluting stent.
BACKGROUND
We compared the effect of arterial remodeling on intimal hyperplasia (IH) after the implantation of a sirolimus-eluting stent (SES) and a paclitaxel-eluting stent (PES).


METHODS
The study population consisted of patients with positive or intermediate remodeling and negative remodeling.


RESULTS
Sixty-nine patients had positive or intermediate remodeling and 107 patients had negative remodeling. At follow-up, late loss was significantly larger (0.58 +/- 0.65 vs. 0.38 +/- 0.55 mm; p = 0.026) in the patients with positive or intermediate remodeling. The IH volume (22.6 +/- 26.2 vs. 12.4 +/- 17.4 mm(3); p = 0.002) and the percent IH (12.9 +/- 14.8 vs. 7.0 +/- 9.6%; p = 0.002) were significantly higher in the patients with positive or intermediate remodeling. Compared to negative remodeling, the IH volume was higher in the PES patients with positive or intermediate remodeling, but this difference was not noted in the SES patients. Multiple-regression analysis revealed that arterial remodeling was a significant independent variable for predicting IH volume in the PES patients (p = 0.018). A positive correlation was found between the remodeling index and the IH volume in the PES patients (r = 0.234, p = 0.028), but not in the SES patients.


CONCLUSIONS
This prospective observational intravascular ultrasound study showed that drug-eluting stents may have a different effect on reducing IH accumulation in lesions with preinterventional positive remodeling characteristics which may be related to the different properties of the drug and delivery platform.
Kang
Woong Chol
WC
Division of Cardiology, Gachon University of Medicine and Science, Incheon, Korea.
Ahn
Taehoon
T
Moon
Chan Il
CI
Lee
Kyunghoon
K
Han
Seung Hwan
SH
Shin
Eak Kyun
EK
Kim
Jung-Sun
JS
Ko
Young-Guk
YG
Choi
Donghoon
D
Jang
Yangsoo
Y
Kim
Byoung-Keuk
BK
Oh
Seong Jin
SJ
Jeon
Dong Woon
DW
Yang
Joo-Young
JY
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D012044:Regression Analysis; D020123:Sirolimus / Q000008:administration & dosage*; D050257:Tubulin Modulators / Q000008:administration & dosage; D017539:Tunica Intima / Q000473:pathology; D018084:Ultrasonography, Interventional
D007166:Immunosuppressive Agents; D050257:Tubulin Modulators; D017239:Paclitaxel; D020123:Sirolimus