Early vascular healing after implantation of the polymer-free biolimus-eluting stent or the ultrathin strut biodegradable polymer sirolimus-eluting stent in patients with ST-segment elevation myocardial infarction. Issue 3 (4th January 2022)

• Record Type: Journal Article
• Authors: Hansen, Kirstine N.; Maeng, Michael; Antonsen, Lisbeth; Maehara, Akiko; Jakobsen, Lars; Ellert, Julia; Terkelsen, Christian J.; Ahlehoff, Ole; Thim, Troels; Fallesen, Christian O.; Noori, Manijeh; Veien, Karsten T.; Jensen, Lisette O.; Christiansen, Evald H.
• Is Part Of: Coronary artery disease. Volume 33:Issue 3(2022)
• Page Start: 196
• Page End: 205
• Publication Date: 2022-01-04
• Subjects: ischemic heart disease -- percutaneous coronary intervention -- vascular healing -- ST-segment elevation myocardial infarction; Coronary heart disease -- Periodicals; Coronary Disease -- Indexes; Coronary Disease -- Periodicals; 616.123005
• DOI: 10.1097/MCA.0000000000001113
• Languages: English
• ISSNs: 0954-6928

Abstract

Abstract : Objective: To evaluate the difference in early vascular healing between the ultrathin-strut biodegradable-polymer sirolimus-eluting Orsiro stent (O-SES) and the polymer-free biolimus-A9-eluting BioFreedom stent (BF-BES), assessed with optical coherence tomography (OCT) after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarctions (STEMIs). Methods: Eighty patients with STEMI who underwent primary PCI were randomly allocated 1:1 to treatment with BF-BES or O-SES. OCT was acquired after PCI and at 1-month follow-up. The primary endpoint was 1-month OCT-assessed vascular healing index based on the presence of uncovered and malapposed stent struts and intraluminal filling defects where low vascular healing index indicated favorable vascular healing. Results: At 1-month, the vascular healing index was similar in O-SES 11.5 [interquartile range (IQR) 9.5–17.5], compared to BF-BES 11.5 (IQR 7.1–12.5; P = 0.14). Percentage of uncovered struts [O-SES 31.5% (IQR 20.7–41.9), P = 0.43] vs. BF-BES 27.8% (IQR 19.4–41.9; P = 0.44), and median volume of neointimal hyperplasia [O-SES 4.9 mm 3 (IQR 1.4–13.1) vs. BF-BES 7.1 mm 3 (IQR 2.8–17.0), P = 0.18] did not differ significantly between the two stent groups. Complete coverage was not observed in any of the stents. The percentages of stents with malapposition did not differ significantly (O-SES 87.1% vs. BF-BES 71.4%, P = 0.14) whereas percentage of malapposed struts [O-SES 3.5% (IQR 0.8–5.5) vs. BF-BES 0.8% (IQR 0.0–1.8), P = 0.003] was lower in the BF-BES group. Conclusion: In patients with STEMI, the drug-coated BF-BES and the thin strut O-SES had similar vascular healing index at 1-month. However, the thin O-SES struts were more often malapposed.