Comparison of Vascular Remodeling in Patients Treated With Sirolimus-Versus Zotarolimus-Eluting Stent Following Acute Myocardial Infarction

作者：Kang Ki Woon^*; Ko Young Guk; Shin Dong Ho; Kim Jung Sun; Kim Byeong Keuk; Choi Donghoon; Jang Yangsoo; Hong Myeong Ki

来源：Clinical Cardiology, 2012, 35(1): 49-54.

DOI：10.1002/clc.20988

Background: The differences in the vascular response to stent implantation or in the incidence of late acquired stent malapposition among different types of drug-eluting stents are not well known in patients with acute myocardial infarction (MI).
Hypothesis: The pattern of vascular remodeling and degree of neointimal proliferation were different depending on the different types of drug-eluting stents.
Methods: This study used intravascular ultrasound (IVUS) to investigate vascular remodeling in patients treated with implantation of sirolimus-eluting stents (SESs) vs zotarolimus-eluting stents (ZESs) following acute MI. The study population consisted of 100 patients with acute MI who were treated either with SES (n = 41) or ZES (n = 59) and underwent both poststenting and 9-month follow-up IVUS examination. Serial vascular changes surrounding stented segments were compared between SES-and ZES-treated lesions.
Results: Percentage of neointimal volume obstruction at follow-up was significantly smaller in SES-treated compared to ZES-treated lesions (2.8 +/- 7.1% vs 18.1 +/- 15.7%, respectively; P< 0.001). However, positive vascular remodeling, which was defined as greater than 10% increase in external elastic membrane volume index (31.7% vs 10.2%, respectively, P = 0.007), and late acquired stent malapposition (12.0% vs 0%, respectively, P = 0.006) occurred more frequently in SES-treated than in ZES-treated lesions.
Conclusions: The pattern of vascular remodeling, including positive remodeling, late acquired stent malapposition, and degree of neointimal proliferation might be different depending on the different types of drug-eluting stents in patients with acute MI.

• 出版日期2012-1