Influence of Plaque Characteristics on Early Vascular Healing in Patients With ST-Elevation Myocardial Infarction

Hansen, Kirstine Nørregaard; Antonsen, Lisbeth; Maehara, Akiko; Mæng, Michael; Ellert, Julia; Ahlehoff, Ole; Veien, Karsten Tange; Hansen, Knud Nørregaard; Noori, Manijeh; Fallesen, Christian Oliver; Thim, Troels; Christiansen, Evald Høj; Jensen, Lisette Okkels

doi:10.1016/j.carrev.2020.09.033

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…These results could differ due to the 12-month difference in follow-up time between the two studies. In a previous analysis on BF-BES, acquired malapposition after 1 month was mainly due to dissolved thrombus jailed behind the stent struts, however, remodeling and stent overlap may also enhance the risk of acquired malapposition at early follow-up [33].…”

Section: Discussionmentioning

confidence: 99%

Early vascular healing after implantation of the polymer-free biolimus-eluting stent or the ultrathin strut biodegradable polymer sirolimus-eluting stent in patients with ST-segment elevation myocardial infarction

Hansen

Mæng

Antonsen

et al. 2022

Coronary Artery Disease

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Objective To evaluate the difference in early vascular healing between the ultrathin-strut biodegradable-polymer sirolimus-eluting Orsiro stent (O-SES) and the polymerfree biolimus-A9-eluting BioFreedom stent (BF-BES), assessed with optical coherence tomography (OCT) after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarctions (STEMIs).Methods Eighty patients with STEMI who underwent primary PCI were randomly allocated 1:1 to treatment with BF-BES or O-SES. OCT was acquired after PCI and at 1-month follow-up. The primary endpoint was 1-month OCT-assessed vascular healing index based on the presence of uncovered and malapposed stent struts and intraluminal filling defects where low vascular healing index indicated favorable vascular healing. ResultsAt 1-month, the vascular healing index was similar in O-SES 11.5 [interquartile range (IQR) 9.5-17.5], compared to BF-BES 11.5 (IQR 7.1-12.5; P = 0.14). Percentage of uncovered struts [O-SES 31.5% (IQR 20.7-41.9), P = 0.43] vs. BF-BES 27.8% ; P = 0.44), and median volume of neointimal hyperplasia [O-SES 4.9 mm 3 (IQR 1.4-13.1) vs. BF-BES 7.1 mm 3 (IQR 2.8-17.0), P = 0.18] did not differ significantly between the two stent groups. Complete coverage was not observed in any of the stents. The percentages of stents with malapposition did not differ significantly (O-SES 87.1% vs. BF-BES 71.4%, P = 0.14) whereas percentage of malapposed struts [O-SES 3.5% (IQR 0.8-5.5) vs. BF-BES 0.8% (IQR 0.0-1.8), P = 0.003] was lower in the BF-BES group. ConclusionIn patients with STEMI, the drug-coated BF-BES and the thin strut O-SES had similar vascular healing index at 1-month. However, the thin O-SES struts were more often malapposed.

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Section: Discussionmentioning

confidence: 99%

Early vascular healing after implantation of the polymer-free biolimus-eluting stent or the ultrathin strut biodegradable polymer sirolimus-eluting stent in patients with ST-segment elevation myocardial infarction

Hansen

Mæng

Antonsen

et al. 2022

Coronary Artery Disease

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“…Furthermore, another OCT study in the STEMI population compared the difference in vascular healing between patients with ruptured plaques (RPs) and non-ruptured plaques (NRPs) one month following PCI with DCS implantation. Interestingly, the rate of uncovered struts was similar between the two groups, with 26.5% in the RP group and 28.1% in the NRP group [ 35 ]. The LEADERS FREE trial compared the safety and efficacy of one-month DAPT after PCI with DCS and BMS solely in HBR patients.…”

Section: Assessment Of Stent Healing By Oct One Month Following Pci A...mentioning

confidence: 99%

Importance of Short-Term Neointimal Coverage of Drug-Eluting Stents in the Duration of Dual Antiplatelet Therapy

Fluder-Wlodarczyk,

Pawłowski,

Chuchra

et al. 2024

JCM

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Dual antiplatelet therapy (DAPT) is mandatory after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation, but optimal DAPT duration remains a topic of intense discussion. The shorter regimen of DAPT might be especially beneficial for high-bleeding-risk (HBR) patients. Novel stent platforms have been designed with innovations that should facilitate vessel healing following stent implantation and enable short DAPT. This review aimed to summarize evidence of the neointimal coverage of short-term stents and their implications for DAPT duration. Results from histological and optical coherence tomography (OCT) studies confirm the significant role of uncovered struts after the implantation of a stent in patients presenting with late stent thrombosis. Several studies have shown favorable vessel healing at one month (with 83.2% of covered struts, on average) and three months following stent implantation (with 93.3% of covered struts, on average). Solely HBR patient trials have proven that one month of DAPT can be applicable and safe in this population. Three-month DAPT was tested in a more diverse population and remains effective and safe in comparison to a longer DAPT regimen. That evidence proves that short-term DAPT might be applicable, especially for HBR patients.

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Influence of Plaque Characteristics on Early Vascular Healing in Patients With ST-Elevation Myocardial Infarction

Cited by 2 publications

References 29 publications

Early vascular healing after implantation of the polymer-free biolimus-eluting stent or the ultrathin strut biodegradable polymer sirolimus-eluting stent in patients with ST-segment elevation myocardial infarction

Early vascular healing after implantation of the polymer-free biolimus-eluting stent or the ultrathin strut biodegradable polymer sirolimus-eluting stent in patients with ST-segment elevation myocardial infarction

Importance of Short-Term Neointimal Coverage of Drug-Eluting Stents in the Duration of Dual Antiplatelet Therapy

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