title: Coronary arterial remodeling and out-stent plaque change after drug-eluting stent implantation--comparison between zotarolimus-eluting stents and paclitaxel-eluting stents.
abstract: BACKGROUND
  Out-stent plaque characteristics and eosinophilic inflammatory response, which correlates with positive remodeling after first-generation drug-eluting stent implantation, may be associated with late restenosis and very late stent thrombosis. The differences of out-stent plaque characteristics were compared between paclitaxel-eluting stents (PES) and zotarolimus-eluting stents (ZES), using integrated backscatter-intravascular ultrasound (IB-IVUS).
  
  
  RESULTS
  Of 78 patients enrolled, 25 receiving PES and 25 receiving ZES had adequate IVUS assessment. Volumetric IVUS analysis was performed after stenting and at 8-month follow-up. Out-stent plaque change in the stented segment was compared on IB-IVUS. The relationship between systemic inflammatory response and out-stent plaque change was evaluated. In PES, vessel volume significantly increased (365-389 mm(3), P<0.0001), whereas it did not change in ZES (315-314 mm(3), P=0.81). In culprit lesions at baseline in PES, fibrous plaque tended to increase (3.1-3.6mm(2), P=0.051) and lipid plaque significantly increased (4.3-5.1mm(2), P=0.02), whereas in ZES the fibrous plaque significantly increased (2.9-4.0mm(2), P<0.0001) but lipid plaque significantly decreased (5.1-3.6mm(2), P<0.0001). Systemic eosinophil increase was significantly correlated with positive remodeling and out-stent lipid plaque increase.
  
  
  CONCLUSIONS
  Chronic out-stent plaque change in ZES consisted of less positive remodeling and more favorable effects on out-stent plaque characteristics than PES. Systemic eosinophil change might be a marker of out-stent lipid plaque change.
authors.affiliation: Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Muraoka
authors.forename: Shinjo
authors.initials: S
authors.lastname: Sonoda
authors.forename: Kuninobu
authors.initials: K
authors.lastname: Kashiyama
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Kamezaki
authors.forename: Yuki
authors.initials: Y
authors.lastname: Tsuda
authors.forename: Masaru
authors.initials: M
authors.lastname: Araki
authors.forename: Masahito
authors.initials: M
authors.lastname: Tamura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Abe
authors.forename: Masahiro
authors.initials: M
authors.lastname: Okazaki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D023903:Coronary Restenosis / Q000453:epidemiology / Q000517:prevention & control; D054855:Drug-Eluting Stents; D004804:Eosinophils / Q000166:cytology / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage; D018084:Ultrasonography, Interventional; D014657:Vasculitis / Q000188:drug therapy / Q000453:epidemiology; D020257:Ventricular Remodeling / Q000187:drug effects*
chemical_list: D050257:Tubulin Modulators; C489443:zotarolimus; D017239:Paclitaxel; D020123:Sirolimus