Early Vascular Response to Ultrathin Biodegradable Polymer Sirolimus-Eluting Stents for the Treatment of ST-Elevation Myocardial Infarction After Plaque Rupture

Yosuke Oishi; Hiroaki Tsujita; Kunihiro Ogura; Naoki Matsukawa; Hideaki Tanaka; Ryota Masaki; Koshiro Sakai; Teruo Sekimoto; Seita Kondo; Shigeto Tsukamoto; Hidenari Matsumoto; Hiroyoshi Mori; Ken Arai; Kosuke Nomura; Syunya Sato; Myong Hwa Yamamoto; Ryota Kosaki; Kohei Wakabayashi; Rikuo Sakai; Taito Arai; Hiroshi Suzuki; Masahiko Ochiai; Toshiro Shinke

doi:10.1536/ihj.20-458

Why the study?

The early vascular response to ultrathin biodegradable polymer sirolimus-eluting stents in patients with STEMI undergoing primary PCI had not been investigated.

Structured PICO

P

Population

20 consecutive patients with ST-elevation myocardial infarction (STEMI) caused by plaque rupture undergoing primary percutaneous coronary intervention (PCI), mean age 62.7, 85% male, single-center (Japan). Key exclusions: cardiogenic shock, left main disease at culprit lesion, reference vessel diameter <2.0 or >4.5 mm, chronic kidney disease (creatinine >2.0 mg/dL), maintenance dialysis.

I

Intervention

Biodegradable polymer sirolimus-eluting stents (BP-SES) with ultrathin struts (60-80 μm) implanted via OCT-guided PCI, followed by dual antiplatelet therapy (aspirin 81-200 mg plus either clopidogrel 300 mg or prasugrel 20 mg loading, then continued for 12 months).

O

Outcome

Incomplete stent apposition measured as the percentage of malapposed struts at 2 weeks follow-up assessed by optical coherence tomography (OCT).surrogate

Limitations

Single center
Small sample size
No control group for head-to-head comparison
Not evaluated by other imaging modalities such as intravascular ultrasound or angioscopy

Implication

In STEMI patients with plaque rupture, biodegradable polymer sirolimus-eluting stents demonstrated rapid early vascular healing with significant reductions in malapposed struts and atherothrombotic burden at 2 weeks.

Abstract

Recent clinical studies suggest that newer-generation drug-eluting stents that combine ultrathin struts and nanocoating (biodegradable polymer sirolimus-eluting stents, BP-SES) could improve long-term clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). However, the early vascular response to BP-SES in these patients has not been investigated so far.

Discussion

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Cite This Study

Oishi et al. (2021) studied this question.

synapsesocial.com/papers/6a6fad2a26a7f98052dc4b0f https://doi.org/10.1536/ihj.20-458

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Early Vascular Response to Ultrathin Biodegradable Polymer Sirolimus-Eluting Stents for the Treatment of ST-Elevation Myocardial Infarction After Plaque Rupture

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Early Vascular Response to Ultrathin Biodegradable Polymer Sirolimus-Eluting Stents for the Treatment of ST-Elevation Myocardial Infarction After Plaque Rupture

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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