Abstract 14273: Angioscopic Evaluation of Arterial Repair Following Second Generation Drug-eluting Stent Implantation in Acute Coronary Syndrome: Comparison With Non-Acute Coronary Syndrome
Introduction: Arterial repair following the implantation of a second generation drug-eluting stent (2nd DES) in acute coronary syndrome (ACS) remains to be elucidated. We sought to investigate the arterial repair by angioscopy in patients with ACS and in those with non-ACS following 2nd DES implantation.
Methods: We performed coronary angioscopy following percutaneous coronary intervention (PCI) between April 2013 and August 2015 for 84 2nd DESs in 58 patients. Angioscopy was done between 2 and 6 months from PCI. ACS (27 stents from 19 patients) and non-ACS (57 stents from 39 patients) were compared. We evaluated dominant neointimal coverage (NIC) grade through the stent, heterogeneity of NIC, yellow color grade of the stented segment and presence of thrombus. NIC was graded as follows: grade 0, stent struts exposed; grade 1, struts bulging into the lumen, although covered; grade 2, struts embedded in the neointima, but translucent; grade 3, struts fully embedded and invisible. The yellow color grade of the stented segment was graded as follows: grade 0, white; grade 1, light yellow; grade 2, yellow; grade 3, bright yellow.
Results: Follow-up period was similar between ACS and non-ACS (135±24 days versus 141±21 days, P=0.33). Dominant NIC (P=0.36), heterogeneity of NIC (P=0.32) and frequency of thrombus (30% in ACS versus 35% in non-ACS, P=0.62) were similar between ACS and non-ACS. Yellow color grade was significantly higher in ACS than in non-ACS (see figure, P=0.034).
Conclusions: Second generation DES implanted in ACS showed comparable arterial repair to that implanted in non-ACS several months after the PCI. However, yellow plaques were predominant in ACS as compared to non-ACS. These findings may justify aggressive lipid-lowering therapy in patients with ACS following PCI.
Author Disclosures: K. Yanaka: None. T. Ishihara: None. O. Iida: None. M. Fujita: None. M. Masuda: None. S. Okamoto: None. K. Nanto: None. T. kanda: None. T. Tsujimura: None. A. Sunaga: None. S. Okuno: None. Y. Matsuda: None. T. Ohasi: None. Y. Hata: None. A. Tsuji: None. H. Kawai: None. M. Uematsu: None.
- © 2016 by American Heart Association, Inc.