Coronary Artery Disease

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Coronary Artery Disease:
doi: 10.1097/MCA.0000000000000131
Original Research

Stenting for ST-segment elevation myocardial infarction is associated with less neointimal hyperplasia in the pooled IVUS analysis from HORIZONS-AMI and the TAXUS IV and V and ATLAS workhorse, long lesion, and direct stent studies

Kobayashi, Nobuakia,b; Maehara, Akikoa,b; Allocco, Dominicc; Witzenbichler, Bernardh; Ellis, Stephen G.d; Turco, Mark A.e; Ormiston, John A.i; Guagliumi, Giulioj; Jiang, Songtaoc; McAndrew, Thomas C.b; Dawkins, Keith D.c; Stone, Gregg W.a,b; Mintz, Gary S.b; Weissman, Neil J.f,g

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Abstract

Objective: To investigate the difference in neointimal hyperplasia (NIH) between ST-segment elevation myocardial infarction (STEMI), stable angina pectoris (SAP), and unstable angina pectoris (UAP).

Patients and methods: From formal core laboratory intravascular ultrasound substudies, we compared NIH after paclitaxel-eluting stents (PES) or bare metal stents (BMS) in STEMI lesions from HORIZONS-AMI trial with SAP and UAP lesions from TAXUS IV, V, and ATLAS studies.

Results: At follow-up, %NIH at the minimum lumen area (MLA) site was less in STEMI (n=212) than in UAP (n=233) and SAP (n=440) lesions treated with PES (19.6 vs. 26.2 vs. 25.0%, P=0.002; all intravascular ultrasound data shown as least-square means in abstract) and less in STEMI (n=66) than in UAP (n=72) and SAP (n=143) lesions treated with BMS (34.0 vs. 26.7 vs. 45.5%, P=0.0003). As a result, MLA at follow-up was larger in STEMI than in UAP and SAP lesions treated with PES (5.9 vs. 5.2 vs. 5.0 mm2, P<0.0001) or treated with BMS (5.1 vs. 4.3 vs. 4.0 mm2, P=0.002). Net volume obstruction ([NIH/stent volume]×100) at follow-up was significantly less in STEMI than in UAP and SAP lesions treated with PES (7.8 vs. 13.4 vs. 13.4%, P<0.0001) or BMS (20.6 vs. 28.5 vs. 32.1%, P<0.0001). Multivariate linear regression analysis showed that STEMI was correlated independently and inversely with net volume obstruction compared with SAP (regression coefficient −6.99, P<0.0001) or UAP (regression coefficient −6.29, P<0.0001).

Conclusion: Implantation of PES or BMS in STEMI compared with UAP and SAP was associated with less NIH.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins

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