Abstract 11615: Angioscopic Observation of Attenuated Arterial Repair 4 Months after Zotarolimus-Eluting Stent Implantation in Patients with Acute Coronary Syndrome
Background: Although zotarolimus-eluting stents (ZES) have shown better arterial repair than first-generation drug-eluting stents, arterial repair following ZES implantation in patients with acute coronary syndrome remains unclear.
Methods: We performed coronary angioscopy 4 months (130±13 days) after ZES implantation in 19 ZES from 17 patients with acute coronary syndrome (ACS), and compared to 26 ZES from 13 patients with stable angina pectoris (SAP, 123±24 days after implantation). Neointimal coverage (NIC) was graded: grade 0, stent struts exposed; grade 1, struts bulged into the lumen, although covered; grade 2, struts embedded by the neointima, but translucent; grade 3, struts fully embedded and invisible. NIC was defined as heterogeneous when the NIC grade variation ≥1. Extent of exposed struts was scored: exp 0, no grade 0; exp 1, grade 0 in limited areas; exp 2, NIC grade 0 <30% of stent surface area; exp 3, NIC grade 0 ≥30%, but not completely exposed; exp 4, struts completely exposed. Existence of thrombus and yellow plaques underneath the stent were also explored.
Results: The dominant NIC grades in ACS were distributed from grade 0 to grade 3, whereas all stents revealed dominant NIC of grade 2 or grade 3 in SAP (P=0.006, see figure). NIC heterogeneity (P=0.73), widely exposed struts (≥exp 3, 26% in ACS versus 8% in SAP, P=0.11), thrombus (50% versus 23%, P=0.73) and yellow plaques (47% versus 58%, P=0.56) were similarly observed in ACS and SAP.
Conclusions: Arterial repair was attenuated 4 months after ZES implantation in patients with acute coronary syndrome compared to those with stable angina pectoris.
- © 2012 by American Heart Association, Inc.