Comparable neointimal healing in patients with stable coronary lesions and acute coronary syndrome: 3-month optical coherence tomography analysis.

Abstract

We aimed to assess a possible difference of the neointimal coverage status and its quality after implantation of the current-generation metallic stents in patients with acute coronary syndrome (ACS) vs. stable coronary lesions (non-ACS). We comprehensively analyzed three prospective single-center observational studies RESTORE (UMIN000033009), HEAL-BioFreedom (UMIN000029692), and HEAL-BioFreedom ACS (UMIN000034769). All patients who received successful optical coherence tomography (OCT) examination at planned 3-month follow-up after stent implantation were analyzed. Study population was divided into two groups, ACS vs. non-ACS groups. We evaluated standard OCT variables, coverage percent, and the quantitative light property values including light intensity, attenuation, and backscatter of neointima. A total of 177 lesions from 154 patients (ACS 44 lesions vs. non-ACS 133 lesions) were analyzed. At 3-month follow-up, coverage percent (ACS 91.5  ±  9.5% vs. non-ACS 91.8  ±  9.0%, P = 0.722) and neointimal thickness (ACS 59.5  ±  32.3 µm vs. non-ACS 58.2  ±  32.3 µm, P = 0.760) did not significantly differ. Light property values were similar between both groups (light intensity 159.29  ±  72.20 vs. 159.45   ± 63.78, P = 0.654; light attenuation 0.88  ±  0.26 vs. 0.87   ±  0.24 m-1, P = 0.988; backscatter 4.86   ±  0.58 vs. 4.83   ±  0.57, P = 0.812). The similarity of the neointimal quality in ACS and non-ACS patients was consistent across the 6 different types of current-generation metallic stents (P for interaction  > 0.05). Our findings suggested the comparable neointimal characteristics 3 months after implantation of the current-generation metallic stents in patients with ACS and stable coronary lesions by quantitative OCT methodology.

• Authors: Yuma Hamanaka, Yohei Sotomi, Tomoaki Kobayashi, Takashi Omatsu, Jouke Dijkstra, Yasushi Sakata, Atsushi Hirayama, Akio Hirata, Yoshiharu Higuchi
• Journal: The international journal of cardiovascular imaging (Int J Cardiovasc Imaging) Vol. 37 Issue 7 Pg. 2095-2105 (Jul 2021) ISSN: 1875-8312 [Electronic] United States
• PMID: 33591475 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature.

Topics

• Acute Coronary Syndrome (diagnostic imaging, surgery)
• Coronary Vessels (diagnostic imaging, surgery)
• Drug-Eluting Stents
• Humans
• Neointima
• Percutaneous Coronary Intervention (adverse effects)
• Predictive Value of Tests
• Prospective Studies
• Tomography, Optical Coherence
• Treatment Outcome