Abstract 14333: Irregular Protrusion and Uncover Stent Struts Correlate With Acute Coronary Syndrome - An OCT Study
Introduction: In these drug eluting era, the adverse event after stent implantation still remains clinically important problem. Patients with acute coronary syndrome (ACS) suffered from a higher incidence of adverse event than stable angina pectoris (SAP). Optical coherence tomography (OCT) enable us to detect various OCT findings after stent implantation. Irregular protrusion detected after stent implantation, malapposition for uncovered strut at follow up are one of the cause of adverse event at follow up. Using OCT, we evaluated the difference of OCT findings after stenting and for at follow up according to ACS and for SAP culprit lesions.
Methods: We examined 118 culprit coronary lesions treated with drug eluting stents which has OCT examination at baseline and 9-month follow up (ACS 26 lesions and SAP 92 lesions). OCT evaluation at baseline includes presence of edge dissection, irregular protrusion and malapposition just after stent implantation. At 9-month follow up, the frequency of uncovered strut was evaluated at every 1 mm interval.
Results: The incidence of irregular protrusion was significantly higher in ACS culprit lesion than in SAP at baseline (88.5% vs. 55.4%, P=0.002). The incidence of edge dissection and malapposition were similar between the two groups. A total of 29,103 stent struts was analyzed and the percentage of uncovered strut was 8.5% in overall subjects. ACS culprit lesion showed a higher incidence of uncovered strut than SAP (11.3±9.3% vs. 6.9±7.8%, P=0.009). Logistic regression analysis showed that ACS culprit lesion was a predictor of irregular protrusion at baseline (OR: 6.16, 95%CI: 1.97-27.26, P=0.001). Moreover, in liner regression, ACS culprit lesion was associated with the rate of uncover stent struts (P=0.018).
Conclusions: ACS culprit lesions correlates to presence of irregular protrusion at baseline for uncovered struts at 9-month follow up. These findings may be one of the reasons for a higher incidence of adverse event in ACS.
Author Disclosures: T. Ueda: None. A. Okamura: None. D. Kamon: None. Y. Sugawara: None. T. Isojima: None. T. Soeda: None. M. Watanabe: None. H. Kawata: None. R. Kawakami: None. H. Okura: None. Y. Saito: Research Grant; Significant; Grants-in-Aid for Scientific Research (B), Challenging Exploratory Research (FY 2015), Health, Labour and Welfare Scientific Research. Other Research Support; Modest; Nihon Medi-Physics Co.,Ltd., Chugai Pharmaceutical Co., Ltd., Medtronic, Inc., Pfizer Japan Inc.. Other Research Support; Significant; MSD K.K. a subsidiary of Merck & Co., Inc., Daiichi Sankyo Co., Ltd., Bayer Holding Ltd., Baxter Ltd., Otsuka Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Astellas Pharma Inc., Takeda Pharmaceutical Co., Ltd., Ono Pharmatical Co., Ltd., Teijin Pharma Ltd., Mitsubishi Tanabe Pharma Corporation, Eisai Co., Ltd., ZERIA Pharmaceutical Co., Ltd.. Honoraria; Modest; Otsuka Pharmaceutical Co., Ltd, Takeda Pharmaceutical Co., Ltd, Mitsubishi Tanabe Pharma Corporation, Daiichi Sankyo Co., Ltd, MSD K.K. a subsidiary of Merck & Co., Inc, Novartis Pharma K.K., Bayer Holding Ltd, Kyowa Hakko Kirin Co., Ltd, Astellas Pharma Inc, Ono Pharmatical Co., Ltd, Pfizer Japan Inc.. Consultant/Advisory Board; Modest; Novartis Pharma K.K., Ono Pharmatical Co., Ltd, Pfizer Japan Inc..
- © 2016 by American Heart Association, Inc.