OBJECTIVE: Neoatherosclerosis or atherosclerosis progression is one of the mechanisms of long-term stent failure. Yellow plaque detected by angioscopy has been associated with advanced atherosclerosis and the future risk of a coronary event. We compared the yellow colour of the stented segment between zotarolimus-eluting stents (ZES) and everolimus-eluting stents (EES) at 1 year after implantation. DESIGN: Cross-sectional study. PATIENTS: Consecutive patients underwent angioscopic examination 1 year after the implantation of ZES (n=45) or EES (n=45) at a de novo native coronary lesion. MAIN OUTCOME MEASURES: The maximum yellow colour grade (grade 0-3) of the stented segment, maximum and minimum neointima coverage grade (grade 0-2) and the presence of thrombus were examined. The neointima heterogeneity index was calculated as maximum - minimum coverage grade. RESULTS: Maximum yellow colour grade was higher in EES than in ZES (1.3±0.9 vs 0.4±0.8, p<0.001) and maximum (2.0±0.2 vs 1.2±0.5, p<0.001) and minimum (1.5±0.6 vs 0.7±0.5, p<0.001) coverage grade was higher in ZES than in EES. The neointima heterogeneity index was not different between ZES and EES (0.4±0.5 vs 0.5±0.6, p=0.42). The incidence of thrombus was very low and was not different between ZES and EES (2% vs 4%, p=0.55). CONCLUSIONS: Although both ZES and EES had good healing with homogeneous neointima coverage and a low incidence of thrombus, EES had more advanced atherosclerosis as shown by the presence of higher grade yellow plaque than ZES at 1 year after implantation.
OBJECTIVE:Neoatherosclerosis or atherosclerosis progression is one of the mechanisms of long-term stent failure. Yellow plaque detected by angioscopy has been associated with advanced atherosclerosis and the future risk of a coronary event. We compared the yellow colour of the stented segment between zotarolimus-eluting stents (ZES) and everolimus-eluting stents (EES) at 1 year after implantation. DESIGN: Cross-sectional study. PATIENTS: Consecutive patients underwent angioscopic examination 1 year after the implantation of ZES (n=45) or EES (n=45) at a de novo native coronary lesion. MAIN OUTCOME MEASURES: The maximum yellow colour grade (grade 0-3) of the stented segment, maximum and minimum neointima coverage grade (grade 0-2) and the presence of thrombus were examined. The neointima heterogeneity index was calculated as maximum - minimum coverage grade. RESULTS: Maximum yellow colour grade was higher in EES than in ZES (1.3±0.9 vs 0.4±0.8, p<0.001) and maximum (2.0±0.2 vs 1.2±0.5, p<0.001) and minimum (1.5±0.6 vs 0.7±0.5, p<0.001) coverage grade was higher in ZES than in EES. The neointima heterogeneity index was not different between ZES and EES (0.4±0.5 vs 0.5±0.6, p=0.42). The incidence of thrombus was very low and was not different between ZES and EES (2% vs 4%, p=0.55). CONCLUSIONS: Although both ZES and EES had good healing with homogeneous neointima coverage and a low incidence of thrombus, EES had more advanced atherosclerosis as shown by the presence of higher grade yellow plaque than ZES at 1 year after implantation.
Authors: David R Holmes; Martin B Leon; Jeffrey W Moses; Jeffrey J Popma; Donald Cutlip; Peter J Fitzgerald; Charles Brown; Tim Fischell; Shing Chiu Wong; Mark Midei; David Snead; Richard E Kuntz Journal: Circulation Date: 2004-02-10 Impact factor: 29.690