Ontology type: schema:ScholarlyArticle Open Access: True
2018-01-09
AUTHORSYoshihiro Morino, Daisuke Terashita, Hiromasa Otake, Tatsuo Kikuchi, Tetsuya Fusazaki, Nehiro Kuriyama, Takahide Suzuki, Yoshiaki Ito, Kiyoshi Hibi, Hiroyuki Tanaka, Shozo Ishihara, Toru Kataoka, Takashi Morita, Yoritaka Otsuka, Takatoshi Hayashi, Kengo Tanabe, Toshiro Shinke
ABSTRACTThe use of cobalt–chromium everolimus-eluting stents (CoCr-EES) for ST-segment elevation myocardial infarction (STEMI) reduces the incidence of stent thrombosis compared with bare metal stents, and a substantial difference is apparent in the initial 2 weeks. However, vascular behavior during this early period remains unclear. This was a prospective study (MECHANISM-AMI-2W) to investigate early vascular responses in STEMI patients immediately after CoCr-EES implantation and at 2-week follow-up using frequency domain-optical coherence tomography (FD-OCT). The study enrolled 52 patients (age 63.7 ± 11.7 years, male 85.0%), of whom 44 patients were available for complete serial FD-OCT analyses. Both % uncovered struts and % malapposed struts were improved at 2-week follow-up (63 ± 20 vs. 21 ± 14%, p < 0.0001 and 7.3 ± 9.0 vs. 4.7 ± 5.9%, p = 0.005, respectively). Thrombus was decreased, with significant changes in longitudinal length to stent (28.8 ± 27.7 vs. 18.1 ± 20.2%, p = 0.0001) and maximal area (0.93 ± 0.84 vs. 0.65 ± 0.63 mm2, p = 0.034). As a result, the average lumen area was significantly larger at 2 weeks (6.49 ± 1.82 vs. 6.71 ± 1.89 mm2, p = 0.048, respectively). The number of dissection flaps was lower (0.86 ± 1.11 vs. 0.52 ± 0.90%, p = 0.024). In conclusion, this study showed early vascular responses to CoCr-EES for STEMI lesions—including a significant reduction of thrombus—that resulted in lumen enlargement, earlier progression of strut coverage, and improvements in strut apposition and dissection. The combination of these factors may therefore be responsible for the safety of CoCr-EES within the initial 2 weeks. More... »
PAGES14-24
http://scigraph.springernature.com/pub.10.1007/s12928-017-0507-4
DOIhttp://dx.doi.org/10.1007/s12928-017-0507-4
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"description": "The use of cobalt\u2013chromium everolimus-eluting stents (CoCr-EES) for ST-segment elevation myocardial infarction (STEMI) reduces the incidence of stent thrombosis compared with bare metal stents, and a substantial difference is apparent in the initial 2\u00a0weeks. However, vascular behavior during this early period remains unclear. This was a prospective study (MECHANISM-AMI-2W) to investigate early vascular responses in STEMI patients immediately after CoCr-EES implantation and at 2-week follow-up using frequency domain-optical coherence tomography (FD-OCT). The study enrolled 52 patients (age 63.7\u00a0\u00b1\u00a011.7\u00a0years, male 85.0%), of whom 44 patients were available for complete serial FD-OCT analyses. Both % uncovered struts and % malapposed struts were improved at 2-week follow-up (63\u00a0\u00b1\u00a020 vs. 21\u00a0\u00b1\u00a014%, p\u00a0<\u00a00.0001 and 7.3\u00a0\u00b1\u00a09.0 vs. 4.7\u00a0\u00b1\u00a05.9%, p\u00a0=\u00a00.005, respectively). Thrombus was decreased, with significant changes in longitudinal length to stent (28.8\u00a0\u00b1\u00a027.7 vs. 18.1\u00a0\u00b1\u00a020.2%, p\u00a0=\u00a00.0001) and maximal area (0.93\u00a0\u00b1\u00a00.84 vs. 0.65\u00a0\u00b1\u00a00.63\u00a0mm2, p\u00a0=\u00a00.034). As a result, the average lumen area was significantly larger at 2\u00a0weeks (6.49\u00a0\u00b1\u00a01.82 vs. 6.71\u00a0\u00b1\u00a01.89\u00a0mm2, p\u00a0=\u00a00.048, respectively). The number of dissection flaps was lower (0.86\u00a0\u00b1\u00a01.11 vs. 0.52\u00a0\u00b1\u00a00.90%, p\u00a0=\u00a00.024). In conclusion, this study showed early vascular responses to CoCr-EES for STEMI lesions\u2014including a significant reduction of thrombus\u2014that resulted in lumen enlargement, earlier progression of strut coverage, and improvements in strut apposition and dissection. The combination of these factors may therefore be responsible for the safety of CoCr-EES within the initial 2\u00a0weeks.",
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