title: Comparison of vascular remodeling in patients treated with sirolimus-versus zotarolimus-eluting stent following acute myocardial infarction.
abstract: BACKGROUND
  The differences in the vascular response to stent implantation or in the incidence of late acquired stent malapposition among different types of drug-eluting stents are not well known in patients with acute myocardial infarction (MI).
  
  
  OBJECTIVE
  The pattern of vascular remodeling and degree of neointimal proliferation were different depending on the different types of drug-eluting stents.
  
  
  METHODS
  This study used intravascular ultrasound (IVUS) to investigate vascular remodeling in patients treated with implantation of sirolimus-eluting stents (SESs) vs zotarolimus-eluting stents (ZESs) following acute MI. The study population consisted of 100 patients with acute MI who were treated either with SES (n = 41) or ZES (n = 59) and underwent both poststenting and 9-month follow-up IVUS examination. Serial vascular changes surrounding stented segments were compared between SES- and ZES-treated lesions.
  
  
  RESULTS
  Percentage of neointimal volume obstruction at follow-up was significantly smaller in SES-treated compared to ZES-treated lesions (2.8 ± 7.1% vs 18.1 ± 15.7%, respectively; P < 0.001). However, positive vascular remodeling, which was defined as greater than 10% increase in external elastic membrane volume index (31.7% vs 10.2%, respectively, P = 0.007), and late acquired stent malapposition (12.0% vs 0%, respectively, P = 0.006 ) occurred more frequently in SES-treated than in ZES-treated lesions.
  
  
  CONCLUSIONS
  The pattern of vascular remodeling, including positive remodeling, late acquired stent malapposition, and degree of neointimal proliferation might be different depending on the different types of drug-eluting stents in patients with acute MI.
authors.affiliation: Severance Cardiovascular Hospital, Seoul, South Korea.
authors.forename: Ki-Woon
authors.initials: KW
authors.lastname: Kang
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.forename: Dong-Ho
authors.initials: DH
authors.lastname: Shin
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Byeong-Keuk
authors.initials: BK
authors.lastname: Kim
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy*; D058426:Neointima / Q000473:pathology*; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: C489443:zotarolimus; D020123:Sirolimus