Randomized Comparison of Strut Coverage between Ticagrelor and Clopidogrel in Acute Myocardial Infarction at 3-Month Optical Coherence Tomography.
10.3349/ymj.2018.59.5.624
- Author:
Choongki KIM
1
;
Byeong Keuk KIM
;
Sung Jin HONG
;
Chul Min AHN
;
Jung Sun KIM
;
Young Guk KO
;
Donghoon CHOI
;
Myeong Ki HONG
;
Yangsoo JANG
Author Information
1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. kimbk@yuhs.ac
- Publication Type:Original Article
- Keywords:
Neointima;
tomography;
optical coherence;
myocardial infarction;
ticagrelor;
clopidogrel
- MeSH:
Arm;
Drug-Eluting Stents;
Humans;
Myocardial Infarction*;
Neointima;
Tomography, Optical Coherence*
- From:Yonsei Medical Journal
2018;59(5):624-632
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study aimed to compare the effects of ticagrelor and clopidogrel on early neointimal healing assessed with optical coherence tomography (OCT) after drug-eluting stent (DES) implantation in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: AMI patients were randomly assigned to either the ticagrelor or clopidogrel arm. After DES implantation, OCT was performed to assess the percentages of uncovered struts immediately after procedure and 3 months later. RESULTS: Due to early termination, 83 patients out of 106 initially enrolled patients (24% of planned participants) underwent 3-month OCT. Differences in vascular healing patterns between the two groups, including percentage of uncovered struts on 3-month OCT (9.6% vs. 11.7% in ticagrelor vs. clopidogrel, respectively; p=0.867), neointimal thickness, percentage of malapposed struts, and healing scores did not reach statistical significance. The predictors of uncovered strut on 3-month OCT included greater reference vessel diameter [odds ratio (OR)=1.96, p < 0.001] and more malapposed struts (OR=1.12, p=0.003). CONCLUSION: The current study did not explore favorable effect of ticagrelor on 3-month vascular healing after DES implantation. Our findings should only be considered for generating hypothesis, due to insufficient power.
