Primary percutaneous coronary intervention (PCI) represents the preferred reperfusion strategy for patients with ST-segment elevation myocardial infarction (STEMI), since it is more effective than thrombolytic regimens in reducing adverse events, including death. Drug-eluting stents (DES) are currently being widely used in patients with STEMI. The effectiveness of DES to reduce restenosis and the need for revascularization compared with bare-metal stents (BMS) has been documented in randomized controlled trials. The first-generation DESs implanted in STEMI have been associated with delayed healing and incomplete strut coverage. Therefore, in patients with implanted DES, longer duration of dual antiplatelet therapy is needed. The second-generation DESs (ZES and EES) have been improved the drug and polymer, which have been proved to improve neointima healing compared with the first generation DESs. However, the difference of strut coverage between EES and BMS implanted in STEMI patients is unknown. In this study, we assess the neointimal coverage at 3-month and 12-month follow-up in EES and BMS implanted in patients with STEMI by optical coherence tomography.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
The Second Affiliated Hospital of Harbin Medical University
Harbin, Heilongjiang, China
Comparison of the rate of covered struts to the EES vs BMS implanted in STEMI patients by frequency domain optical coherence tomography (FD-OCT).
The covered strut is defined as the strut has definite neointimal over it. And the rate of covered struts was calculated as the number of covered struts divided the number of total struts.
Time frame: 3-month
Comparison of the rate of covered struts to the EES vs BMS implanted in STEMI patients by FD-OCT.
The covered strut is defined as the strut has definite neointimal over it. And the rate of covered struts was calculated as the number of covered struts divided the number of total struts.
Time frame: 12-month
Comparison of the rate of malaposed struts to EES vs BMS implanted in STEMI patients by FD-OCT.
Strut malapposition is defined as struts detached from the vessel wall \> 108μm for EES and \> 101μm for BMS. The rate of malaposed struts is calculated as the number of malaposed struts divided the number of total struts.
Time frame: 3-month
Comparison of the rate of malaposed struts to the EES vs BMS implanted in STEMI patients by FD-OCT.
Strut malapposition is defined as struts detached from the vessel wall \> 108μm for EES and \> 101μm for BMS. The rate of malaposed struts is calculated as the number of malaposed struts divided the number of total struts.
Time frame: 12-month
Major adverse cardiovascular events (MACE)
Time frame: 12-month
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