title: Early Phase Arterial Reaction Following Drug-Eluting and Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction.
abstract: The early phase arterial reaction after implantation of second-generation drug-eluting stents (2nd DES) and baremetal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear.The MECHANISM pilot study is a multi-center prospective registry that enrolled 24 STEMI patients (from 11 centers) who had undergone implantation of everolimus-eluting (n = 6), biolimus A9-eluting (n = 6) or zotarolimus-eluting stents (n = 6), or BMS (n = 6). Scheduled optical coherence tomography (OCT) was performed 2 weeks after implantation, and images were independently analyzed at a core laboratory in a blinded fashion. Intra-stent thrombus was quantitatively analyzed in terms of the maximal area and the percentage of cross-sections with thrombus (the numbers of cross-section with thrombus × 100 divided by total number of cross-sections within the stented segment). More than 90% of struts were already covered 2 weeks after the index procedure, regardless of the stent type. There were no differences in stent diameter, minimal lumen diameter, minimal lumen area, neointimal thickness, or the frequencies of malapposed and uncovered struts among the 4 groups. The quantity of intra-stent thrombus also did not differ among the 4 groups.The results of this pilot study suggest that the 2-week vascular responses seem to be similar among 2nd DES and BMS in STEMI patients. Considering the possible advantage of 2nd DES in the prevention of restenosis, 2nd DES are a feasible option for the treatment of patients with STEMI.
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine.
authors.forename: Ryo
authors.initials: R
authors.lastname: Nishio
authors.forename: Toshiro
authors.initials: T
authors.lastname: Shinke
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Morino
authors.forename: Kengo
authors.initials: K
authors.lastname: Tanabe
authors.forename: Jungo
authors.initials: J
authors.lastname: Furuya
authors.forename: Kaname
authors.initials: K
authors.lastname: Takizawa
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
authors.forename: Ken
authors.initials: K
authors.lastname: Kozuma
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hibi
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirohata
authors.forename: Yoritaka
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Otake
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Takaya
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods; D000970:Antineoplastic Agents / Q000494:pharmacology; D054855:Drug-Eluting Stents / Q000009:adverse effects / Q000145:classification; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D058426:Neointima / Q000175:diagnosis / Q000209:etiology; D010865:Pilot Projects; D011446:Prospective Studies; D020123:Sirolimus / Q000031:analogs & derivatives / Q000494:pharmacology; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods
chemical_list: D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D020123:Sirolimus