Abstract 17535: Differential Arterial Responses to Drug Eluting Stents in Asian Versus Western Population: A Volumetric Intravascular Ultrasound Integrated Analysis
Background: Historical data suggest a possible difference in the efficacy of drug-eluting stents (DES) between Asian and Western populations. Racial differences in paclitaxel sensitivity have also been reported in human cancer cell research. This study aimed to evaluate the differential arterial responses to DES between Japanese (JP) and US patient populations (US).
Methods: Serial (post stent and 8-9 months follow-up) volumetric IVUS data were pooled from 6 randomized trials (SIRIUS, ENDEAVOR III and IV, SPIRIT III, ZoMaxx II, and J-DESsERT), including 414 patients (200 JP: 214 US) treated with sirolimus- (SES) or paclitaxel-eluting stents (PES). Neointimal volume obstruction (%NIH) was obtained as neointimal volume/stent volume. Vessel remodeling during follow-up was assessed by the change of peri-stent plaque volume index (PVI: peri-stent plaque volume/ stent length).
Results: At post procedure, both stents showed no difference between JP and US with respect to target vessel, stent size, PVI, or minimum lumen area (MLA). At follow-up, however, JP treated with PES showed significantly greater %NIH and a smaller MLA compared with US. In PES, a significant difference was also observed in the degree of vessel remodeling surrounding the stent between the 2 populations. In contrast, these differences were not apparent in patients treated with SES. In multivariate analysis, the population was independently associated with %NIH in PES (p<0.0001).
Conclusion: Populational difference in arterial responses may vary depending on DES types. Diverse patient backgrounds as well as possibly different sensitivity to specific DES components may in part account for the differential responses observed in the current study.
- © 2012 by American Heart Association, Inc.