Back to Search
Start Over
Early vascular responses to everolimus-eluting cobalt-chromium stent in the culprit lesions of st-elevation myocardial infarction: results from a multicenter prospective optical coherence tomography study (MECHANISM-AMI 2-week follow-up study).
- Source :
-
Cardiovascular intervention and therapeutics [Cardiovasc Interv Ther] 2019 Jan; Vol. 34 (1), pp. 14-24. Date of Electronic Publication: 2018 Jan 09. - Publication Year :
- 2019
-
Abstract
- The 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 mm <superscript>2</superscript> , 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 mm <superscript>2</superscript> , 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.
- Subjects :
- Aged
Cardiovascular Agents administration & dosage
Cardiovascular Agents adverse effects
Chromium administration & dosage
Chromium adverse effects
Cobalt administration & dosage
Cobalt adverse effects
Coronary Angiography methods
Coronary Vessels diagnostic imaging
Coronary Vessels pathology
Coronary Vessels surgery
Everolimus administration & dosage
Everolimus adverse effects
Female
Follow-Up Studies
Humans
Male
Middle Aged
Percutaneous Coronary Intervention adverse effects
Percutaneous Coronary Intervention instrumentation
Prospective Studies
Treatment Outcome
Drug-Eluting Stents adverse effects
Percutaneous Coronary Intervention methods
ST Elevation Myocardial Infarction surgery
Tomography, Optical Coherence methods
Subjects
Details
- Language :
- English
- ISSN :
- 1868-4297
- Volume :
- 34
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cardiovascular intervention and therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 29318464
- Full Text :
- https://doi.org/10.1007/s12928-017-0507-4