Akazawa Yasuhiro, Matsuo Koshi, Ueda Yasunori, Nishio Mayu, Hirata Akio, Asai Mitsutoshi, Nemoto Takayoshi, Wada Mitsuru, Murakami Ayaka, Kashiwase Kazunori, Kodama Kazuhisa
Cardiovascular Division, Osaka Police Hospital.
Circ J. 2014;78(6):1428-36. doi: 10.1253/circj.cj-14-0085. Epub 2014 Apr 8.
Atherosclerosis progression is thought to be one of the mechanisms of late stent failure. Atherosclerosis progression is detected as yellow plaque formation on angioscopy. Cypher sirolimus-eluting stent has been reported to accelerate atherosclerosis progression, but the influence of Endeavor zotarolimus-eluting stent (Endeavor-ZES) or Xience everolimus-eluting stent (Xience-EES) on atherosclerosis has not been clarified. Therefore, we examined the serial changes in extent of atherosclerosis after the implantation of Endeavor-ZES or Xience-EES.
Consecutive patients who received implantation of Endeavor-ZES (n=25) or Xience-EES (n=30) at de novo lesion of native coronary artery and who had successful angioscopy immediately after stent implantation (baseline) and at 1-year follow-up were included in the study. Change in the maximum yellow color grade (grade 0-3) of the stented segment from baseline to follow-up was examined and was compared between Endeavor-ZES and Xience-EES. The maximum yellow color grade decreased significantly from baseline to follow-up in Endeavor-ZES (1.6±1.1 vs. 0.4±0.8, P<0.001), but it did not change in Xience-EES (1.7±1.0 vs. 1.4±0.7, P=0.23). Although the maximum yellow color grade was not different between Endeavor-ZES and Xience-EES at baseline (P=0.72), it was significantly lower in Endeavor-ZES than in Xience-EES at follow-up (P<0.001).
Atherosclerosis evaluated by yellow color of the plaque was significantly reduced at 1 year after Endeavor-ZES implantation, but was not changed after Xience-EES implantation.
动脉粥样硬化进展被认为是晚期支架失败的机制之一。在血管内镜检查中，动脉粥样硬化进展表现为黄色斑块形成。据报道，西罗莫司洗脱支架会加速动脉粥样硬化进展，但依维莫司洗脱支架（Endeavor-ZES）或依维莫司洗脱支架（Xience-EES）对动脉粥样硬化的影响尚未明确。因此，我们研究了植入Endeavor-ZES或Xience-EES后动脉粥样硬化程度的系列变化。
本研究纳入了连续的患者，这些患者在原发性冠状动脉新发病变处植入了Endeavor-ZES（n=25）或Xience-EES（n=30），并在支架植入后（基线）和1年随访时成功进行了血管内镜检查。检查了支架段从基线到随访的最大黄色等级（0-3级）变化，并在Endeavor-ZES和Xience-EES之间进行了比较。Endeavor-ZES组从基线到随访的最大黄色等级显著降低（1.6±1.1 vs. 0.4±0.8，P<0.001），但Xience-EES组未发生变化（1.7±1.0 vs. 1.4±0.7，P=0.23）。尽管Endeavor-ZES和Xience-EES在基线时的最大黄色等级无差异（P=0.72），但在随访时Endeavor-ZES组显著低于Xience-EES组（P<0.001）。
通过斑块黄色评估的动脉粥样硬化在植入Endeavor-ZES后1年显著减轻，但在植入Xience-EES后未发生变化。
