Impact of Drug Release Kinetics on Vascular Response to Different Zotarolimus-Eluting Stents Implanted in Patients With Long Coronary Stenoses The LongOCT Study (Optical Coherence Tomography in Long Lesions)

被引：51

作者：

Guagliumi, Giulio ^{[1
]}

Ikejima, Hideyuki ^{[1
]}

Sirbu, Vasile ^{[1
]}

Bezerra, Hiram ^{[2
]}

Musumeci, Giuseppe ^{[1
]}

Lortkipanidze, Nikoloz ^{[1
]}

Fiocca, Luigi ^{[1
]}

Tahara, Satoko ^{[2
]}

Vassileva, Angelina ^{[1
]}

Matiashvili, Aleksandre ^{[1
]}

Valsecchi, Orazio ^{[1
]}

Costa, Marco ^{[2
]}

机构：

[1] Osped Riuniti Bergamo, Cardiovasc Dept, Div Cardiol, I-24128 Bergamo, Italy

[2] Case Western Reserve Univ, Univ Hosp Case Med Ctr, Cleveland, OH 44106 USA

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2011年 / 4卷 / 07期

关键词：

drug-eluting stent(s); long lesion; optical coherence tomography; percutaneous coronary intervention; FOLLOW-UP; INTRAVASCULAR ULTRASOUND; NEOINTIMAL COVERAGE; BARE-METAL; STRUT COVERAGE; POLYMER; THROMBOSIS; SAFETY;

D O I：

10.1016/j.jcin.2011.04.007

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives We assessed the in vivo vascular response to a new generation of zotarolimus-eluting stents (ZES) with prolonged drug release (Resolute ZES-SR, Medtronic Vascular, Santa Rosa, California) compared with ZES with faster kinetics (Endeavor ZES-FR, Medtronic Vascular) by optical coherence tomography. Background Local drug release kinetics has been implicated with antirestenosis efficacy of drug-eluting stents. However, the impact of different release kinetics on vascular response of diseased human coronary arteries remains to be investigated. Methods The study population consisted of 43 patients with long lesions in native coronary vessels treated with multiple overlapping ZES. Twenty-one patients treated with ZES-SR were compared with 22 patients treated with ZES-FR from the ODESSA (Optical coherence tomography for DES SAfety) study. The primary endpoint was in-stent neointimal hyperplasia as assessed by optical coherence tomography at 6-month follow-up. Coprimary endpoints were the percentage of uncovered and malapposed struts. Results Strut-level median neointimal thickness was 0.11 mm (interquartile range [IQR]: 0.07 to 0.15 mm) in ZES-SR and 0.31 mm (IQR: 0.27 to 0.42 mm) in ZES-FR, respectively (p < 0.001). The 6-month rate of uncovered struts per patient was 7.38% (IQR: 3.06% to 12.72%) in ZES-SR and 0.00% (IQR: 0.00% to 0.00%) in ZES-FR (p < 0.001); rate of malapposed and uncovered struts was 1.47% (IQR: 0.32% to 4.23%) in ZES-SR and 0.00% (IQR: 0.00% to 0.00%) in ZES-FR (p < 0.001). Conclusions This study demonstrated the impact of different release kinetics on human in vivo vascular response to ZES implantation. The new generation of ZES-SR compared with ZES-FR had better suppression of the neointimal response but higher proportion of uncovered and malapposed struts at 6-month optical coherence tomography follow-up. (Optical Coherence Tomography in Long Lesions [LongOCT]; NCT01133925) (J Am Coll Cardiol Intv 2011;4:778-85) (C) 2011 by the American College of Cardiology Foundation

引用

页码：778 / 785

页数：8

共 26 条

[1] Strut position, blood flow, and drug deposition - Implications for single and overlapping drug-eluting stents [J].

Balakrishnan, B ;

Tzafriri, AR ;

Seifert, P ;

Groothuis, A ;

Rogers, C ;

Edelman, ER .

CIRCULATION, 2005, 111 (22) :2958-2965

[2] Intracoronary Optical Coherence Tomography: A Comprehensive Review Clinical and Research Applications [J].

Bezerra, Hiram G. ;

Costa, Marco A. ;

Guagliumi, Giulio ;

Rollins, Andrew M. ;

Simon, Daniel I. .

JACC-CARDIOVASCULAR INTERVENTIONS, 2009, 2 (11) :1035-1046

[3] Incomplete stent apposition and very late stent thrombosis after drug-eluting stent implantation [J].

Cook, Stephane ;

Wenaweser, Peter ;

Togni, Mario ;

Billinger, Michael ;

Morger, Cyrill ;

Seiler, Christian ;

Vogel, Rolf ;

Hess, Otto ;

Meier, Bernhard ;

Windecker, Stephan .

CIRCULATION, 2007, 115 (18) :2426-2434

[4] Different Vascular Healing Patterns With Various Drug-Eluting Stents in Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction: Optical Coherence Tomographic Findings [J].

Fan, Chunyu ;

Kim, Jung-Sun ;

Lee, Jung Myung ;

Kim, Tae Hoon ;

Park, Sang Min ;

Wi, Jin ;

Paik, Sung Il ;

Ko, Young-Guk ;

Choi, Donghoon ;

Hong, Myeong-Ki ;

Jang, Yangsoo .

AMERICAN JOURNAL OF CARDIOLOGY, 2010, 105 (07) :972-976

[5] Pathological correlates of late drug-eluting stent thrombosis - Strut coverage as a marker of endothelialization [J].

Finn, Aloke V. ;

Joner, Michael ;

Nakazawa, Gaku ;

Kolodgie, Frank ;

Newell, John ;

John, Mike C. ;

Gold, Herman K. ;

Virmani, Renu .

CIRCULATION, 2007, 115 (18) :2435-2441

[6] Reproducibility of quantitative optical coherence tomography for stent analysis [J].

Gonzalo, Nieves ;

Garcia-Garcia, Hector M. ;

Serruys, Patrick W. ;

Commissaris, Koen H. ;

Bezerra, Hiram ;

Gobbens, Pierre ;

Costa, Marco ;

Regar, Evelyn .

EUROINTERVENTION, 2009, 5 (02) :224-232

[7] Strut Coverage and Vessel Wall Response to Zotarolimus-Eluting and Bare-Metal Stents Implanted in Patients With ST-Segment Elevation Myocardial Infarction The OCTAMI (Optical Coherence Tomography in Acute Myocardial Infarction) Study [J].

Guagliumi, Giulio ;

Sirbu, Vasile ;

Bezerra, Hiram ;

Biondi-Zoccai, Giuseppe ;

Fiocca, Luigi ;

Musumeci, Giuseppe ;

Matiashvili, Aleksandre ;

Lortkipanidze, Nikoloz ;

Tahara, Satoko ;

Valsecchi, Orazio ;

Costa, Marco .

JACC-CARDIOVASCULAR INTERVENTIONS, 2010, 3 (06) :680-687

[8] Optical Coherence Tomography Assessment of In Vivo Vascular Response After Implantation of Overlapping Bare-Metal and Drug-Eluting Stents [J].

Guagliumi, Giulio ;

Musumeci, Giuseppe ;

Sirbu, Vasile ;

Bezerra, Hiram G. ;

Suzuki, Nobuaki ;

Fiocca, Luigi ;

Matiashvili, Aleksandre ;

Lortkipanidze, Nikoloz ;

Trivisonno, Antonio ;

Valsecchi, Orazio ;

Biondi-Zoccai, Giuseppe ;

Costa, Marco A. .

JACC-CARDIOVASCULAR INTERVENTIONS, 2010, 3 (05) :531-539

[9] Endothelial cell recovery between comparator polymer-based drug-eluting stents [J].

Joner, Michael ;

Nakazawa, Gaku ;

Finn, Aloke V. ;

Quee, Shawn Chin ;

Coleman, Leslie ;

Acampado, Eduardo ;

Wilson, Patricia S. ;

Skorija, Kristi ;

Cheng, Qi ;

Xu, Xin ;

Gold, Herman K. ;

Kolodgie, Frank D. ;

Virmani, Renu .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2008, 52 (05) :333-342

[10] Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents [J].

Kastrati, Adnan ;

Mehilli, Julinda ;

Pache, Juergen ;

Kaiser, Christoph ;

Valgimigli, Marco ;

Kelbaek, Henning ;

Menichelli, Maurizio ;

Sabate, Manel ;

Suttorp, Maarten J. ;

Baumgart, Dietrich ;

Seyfarth, Melchior ;

Pfisterer, Matthias E. ;

Schoemig, Albert .

NEW ENGLAND JOURNAL OF MEDICINE, 2007, 356 (10) :1030-1039

← 1 2 3 →