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Late stent failure (thrombosis and restenosis) is an important problem with drug–eluting stent. Although everolimus–eluting stents (EES) are superior to Endeavor–zotarolimus–eluting stents (Endeavor–ZES) in early efficacy, the rate of late stent failure appears higher in EES than in Endeavor–ZES. The mechanism of late stent failure has been reported neoatherosclerosis. Atherosclerosis is detected by angioscopy as yellow plaque, which has been associated with future coronary event. Therefore, we compared the serial changes of yellow plaque appearance after the implantation of Endeavor–ZES and EES.
Consecutive patients who received implantation of Endeavor–ZES (n=25) or EES (n=30) at de novo lesion of native coronary artery were included; and angioscopic examinations were performed immediately after implantation (baseline) and at one–year follow–up. The change of maximum yellow color grade (grade 0 – 3) from baseline to follow–up was compared between Endeavor–ZES and EES groups.
Maximum yellow color grade was not different at baseline (1.67±1.02 vs. 1.56±1.08, p=0.71) but was lower in Endeavor–ZES than in EES at follow–up (0.40±0.76 vs. 1.43±0.74, p<0.0001). Therefore, the reduction in maximum yellow color grade was significantly larger in Endeavor–ZES than in EES (1.29±0.92 vs. 0.38±0.76, p<0.0001).
Endeavor–ZES than EES caused more regression of yellow plaque at the implanted coronary segment, and thus may be more protective against neoatherosclerosis.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Interventional Aspects of CT and Other Novel Imaging Approaches
Abstract Category: 38. TCT@ACC–i2: Intravascular Imaging and Physiology
Presentation Number: 2112–261
- 2013 American College of Cardiology Foundation