Abstract 12598: More Heterogeneous Arterial Healing in Acute Coronary Syndrome than in Stable Angina at 6 to 8 Months after Silorimus-Eluting Stent Implantation: Angioscopic Study
Background: Some angioscopic studies have revealed different grade of heterogeneity of the neointimal coverage between the different drug eluting stents (DES), however it is unclear the correlation between the grade of heterogeneity of the neointimal coverage and condition of the background coronary artery disease, acute coronary syndrome (ACS) or stable angina (SP), in the same DES. Thus, we angioscopically compared the condition of neointimal coverage after sirolimus-eluting stents (SES) implantation between the patients with ACS and SP in detail.
Methods: Six to eight-month follow-up angioscopy was performed in 141 consecutive patients (54 patients with ACS and 87 patietns with SP) with SES implantation. All patients received aspirin (100 mg) and ticlopidine (200 mg) daily until angioscopy. We divided one SES into three segments, proximal, mid and distal segment, and compared the grade of neointimal coverage using 4 categories (0: no coverage to 3: full coverage), incidence of angioscopic thrombus and yellow plaque in each segment between the patients with ACS and SP. We also evaluated heterogeneity score, which is defined by subtracting minimum from maximum grade of each segment, in one stent.
Results: At mid segment of SES, the grade of neointimal coverage was significantly lower in ACS than in SP on the contrary, at proximal and distal segments the grade showed the higher values in ACS as compared to SP (table). As a result, more heterogeneous neointimal coverage was found in ACS than in SP at 6 to 8 months after SES implantation.
Conclusions: At mid segment of SES in ACS as compared to SP, significantly delayed arterial healing was shown at 6 to 8 months after stent implantation while at the other edged segments, tendency of progressed arterial healing was found in ACS, that may be brought to more heterogeneous neointimal coverage in ACS than in SP. This phenomenon may be correlated with the vulnerability of culprit lesion, which usually stands in the mid segment of the stent.
- © 2010 by American Heart Association, Inc.