title: Comparison of Chronic Angioscopic Findings of Bare Metal Stents, 1st-Generation Drug-Eluting Stents and 2nd-Generation Drug-Eluting Stents　- Multicenter Study of Intra-Coronary Angioscopy After Stent (MICASA).
abstract: BACKGROUND
  No previous study has reported a comprehensive comparison of the chronic angioscopic findings after bare metal stent (BMS), and 1st- and 2nd-generation drug-eluting stents (DES).
  
  
  RESULTS
  The Multicenter Study on Intra-Coronary Angioscopy after Stent (MICASA) is a multicenter registry of coronary angioscopy. A total of 264 stents were observed by coronary angioscopy 1 year after PCI. There were 15 BMS, 90 1st-generation DES, and 159 2nd-generation DES. Neointimal coverage (NC) of the stent was classified into 4 grades from 0 (no coverage) to 3 (complete coverage). Yellow color (YC) of plaque at the stented segment was graded from 0 (white) to 3 (bright yellow). Minimum (Min-) and Maximum (Max-) NC grade were significantly lower with 1st- and 2nd-generation DES than with BMS. Although the Max-NC grade was similar, the Min-NC grade was significantly higher for 2nd-generation DES than for 1st-generation DES. Both the YC grade and the incidence of thrombus with 2nd-generation DES were lower than with the 1st-generation DES and were comparable to BMS. Multivariate analysis showed that low-density lipoprotein, 1st-generation DES, and acute coronary syndrome were independent factors for yellow plaque (YG2 or 3), and that hypertension and 1st-generation DES were independent factors for the incidence of thrombus.
  
  
  CONCLUSIONS
  Coronary angioscopy revealed more homogeneous coverage with white neointima and less thrombus after 2nd-generation DES as compared with 1st-generation DES. These findings may explain the favorable clinical outcomes observed for patients treated with 2nd-generation DES. (Circ J 2016; 80: 1916-1921).
authors.affiliation: Department of Cardiology, Hiroshima City Hospital.
authors.forename: Kazuoki
authors.initials: K
authors.lastname: Dai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuoka
authors.forename: Hideo
authors.initials: H
authors.lastname: Kawakami
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sato
authors.forename: Kouki
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nakama
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery; D000368:Aged; D017546:Angioscopy; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D015994:Incidence; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D058426:Neointima / Q000097:blood / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D012042:Registries; D013927:Thrombosis / Q000097:blood / Q000209:etiology / Q000473:pathology / Q000503:physiopathology
chemical_list: D008077:Lipoproteins, LDL