Faculty Information |
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Article types | Original article |
Language | English |
Refereed paper | Refereed |
Title | Comparison of Chronic Angioscopic Findings of Bare Metal Stents, 1st-Generation Drug-Eluting Stents and 2nd-Generation Drug-Eluting Stents- Multicenter Study of Intra-Coronary Angioscopy After Stent(MICASA). |
Journal | Formal name:Circulation journal : official journal of the Japanese Circulation Society Abbreviation:Circ J ISSN code:1347-4820(Electronic)1346-9843(Linking) |
Domestic / Foregin | Domestic |
Volume, Number, Page | 80(9),pp.1916-21 |
Papers・Author | Dai Kazuoki, Matsuoka Hiroshi, Kawakami Hideo, Sato Tetsuya, Watanabe Kouki, Nakama Yasuharu, Ishihara Masaharu |
Publication date | 2016/08 |
Papers・Description | BACKGROUND:No previous study has reported a comprehensive comparison of the chronic angioscopic findings after bare metal stent (BMS), and 1st- and 2nd-generation drug-eluting stents (DES).METHODS AND RESULTS:The Multicenter Study on Intra-Coronary Angioscopy after Stent (MICASA) is a multicenter registry of coronary angioscopy. A total of 264 stents were observed byMETHODS AND RESULTS:coronary angioscopy 1 year after PCI. There were 15 BMS, 90 1st-generation DES, and 159 2nd-generation DES. Neointimal coverage (NC) of the stent was classified into 4 grades from 0 (no coverage) to 3 (complete coverage). Yellow color (YC) of plaque at the stented segment was graded from 0 (white) to 3 (bright yellow). Minimum (Min-) and Maximum (Max-) NC grade were significantly lower with 1st- and 2nd-generation DES than with BMS. Although the Max-NC grade was similar, the Min-NC grade was significantly higher for 2nd-generation DES than for 1st-generation DES. Both the YC grade and the incidence of thrombus with 2nd-generation DES were lower than with the 1st-generation DES and were comparable to BMS. Multivariate analysis showed that low-density lipoprotein, 1st-generation DES, and acute coronary syndrome were independent factors for yellow plaque (YG2 or 3), and that hypertension and 1st-generation DES were independent factors for the incidence of thrombus.CONCLUSIONS:Coronary angioscopy revealed more homogeneous coverage with white neointima and less thrombus after 2nd-generation DES as compared with 1st-generation DES. These findings may explain the favorable clinical outcomes observed for patients treated with 2nd-generation DES. (Circ J 2016; 80: 1916-1921). |
DOI | 10.1253/circj.CJ-16-0121 |
PMID | 27357218 |