title: Comparisons of detailed arterial healing response at seven months following implantation of an everolimus- or sirolimus-eluting stent in patients with ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  The difference of arterial healing response following everolimus-eluting stent (EES) or sirolimus-eluting stent (SES) implantation in patients with ST-segment elevated myocardial infarction (STEMI) has not been compared in detail.
  
  
  METHODS
  Thirty-five patients with STEMI were randomly implanted with an EES or SES (23 EES, 12 SES). At seven months, neointimal thickness (NIT) and strut malapposition were evaluated by optical coherence tomography (OCT) and the grade and heterogeneity of neointimal coverage (NIC) and development of intra-stent thrombi were evaluated by angioscopy.
  
  
  RESULTS
  No significant differences were noted in clinical events experienced by the two groups, although one patient with an EES died following a papillary muscle rupture and one patient with a SES experienced sub-acute stent thrombosis. On OCT, although the EES implants showed a greater NIT than the SES implants (94.8 ± 88.8 μm vs 65.6 ± 63.3 μm, P<0.0001), both the EES and SES showed an excellent suppression of neointimal proliferation in the culprit lesion of STEMI. The frequency of uncovered and malapposed struts of EES was significantly lower than that of SES (2.7% vs. 15.7%, P<0.0001, 0.7% vs. 2.3%, P<0.0001, respectively). The ratio of stents fully covered with neointima of EES group was significantly higher than that of SES group (P=0.04). Angioscopic analysis also showed greater dominant NIC grade with homogenous NIC in EES than in SES (P=0.03, P=0.0002, respectively). The incidence of massive intra-stent thrombus of EES was lower than that of SES (P=0.05).
  
  
  CONCLUSIONS
  For patients with STEMI, EES may promote better arterial healing response than SES.
authors.affiliation: Hyogo Prefectural Awaji Hospital, Division of Cardiovascular Medicine, Department of Internal Medicine, Japan. Electronic address: taktak319@yahoo.co.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sawada
authors.forename: Toshiro
authors.initials: T
authors.lastname: Shinke
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Otake
authors.forename: Taiji
authors.initials: T
authors.lastname: Mizoguchi
authors.forename: Masamichi
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Takuo
authors.initials: T
authors.lastname: Emoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Terashita
authors.forename: Takao
authors.initials: T
authors.lastname: Mizuguchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okamoto
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Sushi-ku
authors.initials: SK
authors.lastname: Kim
authors.forename: Akira
authors.initials: A
authors.lastname: Takarada
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yokoyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery; D054855:Drug-Eluting Stents / Q000639:trends*; D000068338:Everolimus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000601:surgery; D011859:Radiography; D020123:Sirolimus / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects / Q000502:physiology
chemical_list: D000068338:Everolimus; D020123:Sirolimus