Randomized Comparison of Strut Coverage between Ticagrelor and Clopidogrel in Acute Myocardial Infarction at 3-Month Optical Coherence Tomography.

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.

journal_name

Yonsei Med J

journal_title

Yonsei medical journal

authors

Kim C,Kim BK,Hong SJ,Ahn CM,Kim JS,Ko YG,Choi D,Hong MK,Jang Y

doi

10.3349/ymj.2018.59.5.624

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

624-632

issue

5

eissn

0513-5796

issn

1976-2437

pii

59.624

journal_volume

59

pub_type

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