• Eur Heart J Cardiovasc Imaging · May 2015

    Comparative Study

    Comparison of vascular response between everolimus-eluting stent and bare metal stent implantation in ST-segment elevation myocardial infarction assessed by optical coherence tomography.

    • Yasushi Ino, Takashi Kubo, Atsushi Tanaka, Yong Liu, Takashi Tanimoto, Hironori Kitabata, Yasutsugu Shiono, Kunihiro Shimamura, Makoto Orii, Kenichi Komukai, Keisuke Satogami, Yoshiki Matsuo, Takashi Yamano, Tomoyuki Yamaguchi, Kumiko Hirata, Toshio Imanishi, and Takashi Akasaka.
    • Department of Cardiovascular Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan.
    • Eur Heart J Cardiovasc Imaging. 2015 May 1; 16 (5): 513-20.

    AimsThe long-term safety of second-generation everolimus-eluting stents (EESs) in ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of this study was to evaluate the late vascular response after stent implantation in STEMI between EES and bare-metal stent (BMS) by using optical coherence tomography (OCT).Methods And ResultsA prospective OCT examination was performed in 102 patients at 10 months after stent implantation for treatment of STEMI. A total of 1253 frames with 12 772 struts in 61 EESs and 776 frames with 8594 struts in 41 BMSs were analysed. There were no significant differences in the percentage of uncovered struts (2.1 ± 2.8 vs. 1.7 ± 2.7%, P = 0.422) and malapposed struts (0.7 ± 1.3 vs. 0.6 ± 1.2%, P = 0.756) between EES and BMS. The frequency of intra-stent thrombus was comparable between the two stents (13 vs. 10%, P = 0.758). The mean neointimal thickness was smaller in EES compared with BMS (104 ± 39 vs. 388 ± 148 µm, P < 0.001). In-segment binary restenosis and target lesion revascularization was less often seen in EES compared with BMS (3 vs. 17%, P = 0.028 and 2 vs. 12%, P = 0.037, respectively).ConclusionWhen compared with BMS, EES showed a lower rate of stent restenosis, similar frequency of neointimal coverage, stent malapposition, and intra-stent thrombus at 10 months after stent implantation in STEMI. Our results suggest the safety and effectiveness of EES in primary percutaneous coronary intervention for STEMI patients.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

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