title: Early neointimal coverage and vasodilator response following biodegradable polymer sirolimus-eluting vs. durable polymer zotarolimus-eluting stents in patients with acute coronary syndrome –HATTRICK-OCT trial.
abstract: BACKGROUND
  Patients at high bleeding risk would benefit from a shorter dual antiplatelet therapy after PCI. Compared to first-generation devices, the design of newer generation drug-eluting stents may facilitate more rapid anatomical and functional healing of stented vessel based on thinner stent platforms, biodegradable/biocompatible polymers and rapid drug elution.
  
  
  RESULTS
  Forty-four non-diabetic patients with acute coronary syndrome (ACS) and culprit lesion in the LAD were randomized to receive either biodegradable polymer sirolimus-eluting stent (BP-SES) or durable polymer zotarolimus-eluting stent (DP-ZES). Neointimal strut coverage was examined using optical coherence tomography, and vasodilator response on invasive thermodilution-derived coronary flow reserve (CFR) at 3-month follow-up. The primary endpoints were percent uncovered struts and CFR. A total of 425 cross-sections (4,897 struts) were analyzed in the BP-SES group, and 425 cross-sections (5,467 struts) in the DP-ZES group. The percent uncovered struts was lower in the BP-SES group compared with the DP-ZES group, both at strut level (3.9% vs. 8.9%, respectively, P<0.001), and stent level (3.9 ± 3.2% vs. 8.9 ± 6.9%, respectively, P=0.019). No significant difference was found between the 2 groups regarding CFR (3.0 ± 1.3 vs. 3.2 ± 1.0, respectively, P>0.05).
  
  
  CONCLUSIONS
  In non-diabetic patients with ACS, BP-SES provided slightly better stent strut coverage at 3 months compared with DP-ZES, but neither stent was fully covered. No difference in vasodilator response was seen.
authors.affiliation: Heart Center, Satakunta Central Hospital, Pori. pasi.karjalainen@satshp.fi
authors.forename: Pasi P
authors.initials: PP
authors.lastname: Karjalainen
authors.forename: Ville
authors.initials: V
authors.lastname: Varho
authors.forename: Wail
authors.initials: W
authors.lastname: Nammas
authors.forename: Jussi
authors.initials: J
authors.lastname: Mikkelsson
authors.forename: Mikko
authors.initials: M
authors.lastname: Pietilä
authors.forename: Antti
authors.initials: A
authors.lastname: Ylitalo
authors.forename: Juhani K E
authors.initials: JK
authors.lastname: Airaksinen
authors.forename: Jussi
authors.initials: J
authors.lastname: Sia
authors.forename: Kai
authors.initials: K
authors.lastname: Nyman
authors.forename: Fausto
authors.initials: F
authors.lastname: Biancari
authors.forename: Tuomas
authors.initials: T
authors.lastname: Kiviniemi
mesh_terms: D020341:Absorbable Implants; D054058:Acute Coronary Syndrome / Q000503:physiopathology / Q000601:surgery; D000368:Aged; D063566:Biodegradable Plastics; D004311:Double-Blind Method; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058426:Neointima; D011446:Prospective Studies; D020123:Sirolimus / Q000031:analogs & derivatives*; D014664:Vasodilation / Q000187:drug effects*
chemical_list: D063566:Biodegradable Plastics; C489443:zotarolimus; D020123:Sirolimus