Vascular Healing Response after Everolimus-Eluting Stent Implantation in Acute Coronary Syndrome Culprit Lesions: Comparison with Implantation in Stable Angina Pectoris
Vascular Healing Response after Everolimus-Eluting Stent Implantation in Acute Coronary Syndrome Culprit Lesions: Comparison with Implantation in Stable Angina Pectoris
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DOI：
10.6515/acs.201803_34(2).20171115a
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发表时间：
2018-03-01
影响因子：
1.9
通讯作者：
Uemura, Shiro
中科院分区：
文献类型：
--
作者：
Goryo, Yutaka;Kume, Teruyoshi;Uemura, Shiro
背景：使用光学相干断层扫描（OCT）评估急性冠脉综合征（ACS）患者与稳定型心绞痛（SAP）患者罪魁祸首中植入的依维莫司洗脱支架（EES）的新内膜状况。 EES 是第二代药物洗脱支架，最近被证明对 ACS 患者以及 SAP 患者有用。然而，很少有研究分析 EES 的支架内条件，从而在此类 ACS 病变中产生良好的结果。方法：我们评估了 41 名植入 EES 的 ACS 患者（年龄，66.7 +/- 10.3 岁）和 59 名 SAP 患者作为对照（年龄，68.3 +/- 10.7 岁）。支架植入后随访9个月后进行OCT检查，以1mm的间隔评估每个支架支柱的新生内膜覆盖情况。此外，还测量了每个支柱上的新生内膜厚度 (NIT) 并检查了组织特征。结果：ACS (90.8 +/- 88.2 mm) 和 SAP (87.3 +/- 74.2 mm，p = 0.11) 组之间的平均 NIT 无显着差异。 ACS 组中支柱未覆盖的比例 (11.5%) 显着低于 SAP 组 (12.5%, p = 0.03)。各组之间的新内膜组织特征也相似。结论：使用 OCT 观察 ACS 和 SAP 病变之间 EES 植入后的血管反应存在显着差异。然而，这些差异在临床方面被认为很小。我们的 OCT 数据支持在中期随访中接受 ES 植入的患者的良好结果，即使是患有 ACS 的患者也是如此。
Background: To evaluate the neointimal conditions of everolimus-eluting stents (EESs) implanted in culprit lesions of patients with acute coronary syndrome (ACS) compared with stable angina pectoris (SAP) using optical coherence tomography (OCT). EESs are second-generation drug-eluting stents that have recently been shown to be useful in patients with ACS as well as in patients with SAP. However, few studies have analyzed the intra-stent conditions of EESs that can lead to favorable results in such ACS lesions.Methods: We evaluated 41 ACS patients with EES implantation (age, 66.7 +/- 10.3 years) and 59 SAP patients enrolled as controls (age, 68.3 +/- 10.7 years). OCT examinations were performed after 9 months of follow-up after stent implantation, and the condition of the neointimal coverage over every stent strut was assessed in 1-mm intervals. In addition, neointimal thickness (NIT) over each strut was measured and tissue characteristics were examined.Results: There was no significant difference in mean NIT between the ACS (90.8 +/- 88.2 mm) and SAP (87.3 +/- 74.2 mm, p = 0.11) group. The rate of uncovered struts was significantly lower in the ACS group (11.5%) than in the SAP group (12.5%, p = 0.03). Neointimal tissue characteristics were also similar between groups.Conclusions: Vascular responses after EES implantation differed significantly between ACS and SAP lesions using OCT. However, these differences were considered small in clinical terms. Our OCT data support the favorable results of patients with [ES implantation at mid-term follow-up, even in those with ACS.