Comparison of angioscopic findings among second-generation drug-eluting stents. Issue 3 (September 2017)

• Record Type: Journal Article
• Authors: Nishimoto, Yuji; Ueda, Yasunori; Sugihara, Ryuta; Murakami, Ayaka; Ueno, Keisuke; Takeda, Yasuharu; Hirata, Akio; Kashiwase, Kazunori; Higuchi, Yoshiharu; Yasumura, Yoshio
• Is Part Of: Journal of cardiology. Volume 70:Issue 3(2017:Sep.)
• Page Start: 297
• Page End: 302
• Publication Date: 2017-09
• Subjects: Angioscopy -- Drug-eluting stent -- Neiointima -- Neoatherosclerosis -- Very-late stent failure; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2016.11.012
• Languages: English
• ISSNs: 0914-5087

Abstract

Abstract: Background: First-generation drug-eluting stents (DES) have reduced short-term stent failure as compared to bare-metal stents due to the inhibition of neointima hyperplasia, but instead increased the risk of very-late stent failure. Although better outcomes have been reported for second-generation DES than for first-generation DES, the difference in the angioscopic findings at 1-year follow-up has not been adequately elucidated among second-generation DES. Methods: Consecutive 161 patients who received angioscopic examination at 1 year after implantation of second-generation DES, i.e. Nobori biolimus-eluting stents (Terumo, Tokyo, Japan) (N-BES, n = 25), Xience everolimus-eluting stents (Abbot Vascular, Santa Clara, CA, USA; X-EES, n = 95), or Resolute zotarolimus-eluting stents (Resolute Integrity; Medtronic, Minneapolis, MN, USA; R-ZES, n = 41), in de novo native coronary lesions were analyzed. Results: Maximum neointima coverage grade (N-BES, 0.9 ± 0.3; X-EES, 1.2 ± 0.4; R-ZES, 1.5 ± 0.5; p < 0.001) was the highest in R-ZES and lowest in N-BES. Heterogeneity score was higher in R-ZES than in N-BES (N-BES, 0.8 ± 0.4; X-EES, 0.9 ± 0.4; R-ZES, 1.1 ± 0.5; p = 0.007). Maximum yellow color grade and prevalence of thrombus were not different. Multivariate analysis demonstrated that only stent type was associated with maximum neointima coverage grade; stent type and total stent length were associated with heterogeneity score; and stenting for acute coronary syndrome (ACS) and total stent length were associated with maximum yellow color grade. Conclusions: Neointima coverage and heterogeneity were mainly determined by stent type even among second-generation DES, while yellow color was determined mainly by whether target lesion was of ACS.