Abstract 3425: Possible Protection Mechanism Against Yellow Plaque by Neointimal Coverage Following Sirolimus-Eluting Stent in Patients with Acute Myocardial Infarction
Background: Some large trials have revealed that sirolimus-eluting stent (SES) is safe and useful even in the patients with acute myocardial infarction (AMI) alike stable angina (SP). However, whether neointimal formation after SES implantation between AMI and SP are similar or not is unknown. Thus, in this study, we compared the angioscopic findings after 6-month SES implantation between AMI and SP.
Methods: Six-month follow-up angioscope was performed in 16 patients with AMI and 27 patients with SP. All patients received aspirin (100mg) and ticlopidine (200mg) until angioscope. We compared the following angioscopic findings and serum markers between the patients with AMI and SP: angioscopic findings including grade of neointimal coverage (0: no neointimal coverage of stent struts, 1: partial coverage, 2: complete coverage), existence of visible thrombus, and plaque color around stent (0: white, 1: slightly yellow, 2: yellow) and serum markers including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL), hemoglobin A1c (HbA1c), high sensitive C-reactive protein (hs-CRP) and fibrinogen (FBG).
Results: The value of hs-CRP and grade of plaque color were significantly higher in the patients with AMI than SP; nevertheless the patients with AMI showed similar amount of red visible thrombus and significant higher grade of neointimal coverage as compared to the patients with SP (table⇓). The other factors showed no significant differences between the two groups.
Conclusions: SES induced more neointimal formation in the patients with AMI as compared to SP and this phenomenon may protect against yellow (more inflammatous and vulnerable) plaque and may correlate with good results of SES implantation even in AMI.