Abstract 16234: Different Nature of the Inflammatory Reaction in Intracoronary Neo-Intimal Hyperplasia between Sirolimus-Eluting Stents and Bare Metal Stents: An Optical Coherence Tomography Study
Background: It has been suggested that in a small number of autopsy cases, sirolimus-eluting stents (SES) provoked more sustained inflammatory changes in coronary neo-intimal hyperplasia (NIH) than bare metal stents (BMS). Normalized standard deviation using optical coherence tomography (NSD-OCT) has been recently suggested to correlate with the tissue accumulation of CD68 and macrophages in vulnerable plaque lesions in patients with acute coronary syndrome. However, it remains unknown whether NSD-OCT values in NIH in vivo are different between SES and BMS in patients with coronary artery disease.
Objective: To compare post-stent inflammatory responses such as NSD-OCT values in NIH between patients with SES and BMS.
Methods: Thirty-eight patients (14 BMS and 24 SES) underwent OCT during coronary angiography at their post-stent follow-up (mean 6–8 months after stent implantation). Region of interest (ROI) was determined as in NIH. NSD-OCT values in patients with SES were compared with those in patients with BMS. Moreover, high sensitive serum C-reactive protein (hsCRP) concentration was measured.
Results: The NSD-OCT value was significantly higher in the SES group than in the BMS group (0.213 ± 0.004 vs. 0.198 ± 0.006, respectively; p<0.001). The hsCRP level was significantly higher in the SES group than in the BMS group (2.54±1.89 vs. 0.68±0.53 mg/L, respectively; p=0.01). In addition, a significant positive correlation was found between hsCRP and NSD-OCT (p = 0.022).
Conclusions: Higher levels of NSD-OCT and hsCRP after SES implantation suggest sustained inflammatory changes in NIH, which may be prone to provoking late stent thrombosis after SES implantation.
- © 2010 by American Heart Association, Inc.