Randomized Comparison of Strut Coverage between Ticagrelor and Clopidogrel in Acute Myocardial Infarction at 3-Month Optical Coherence Tomography
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Purpose: This study aimed to compare the effects of ticagrelor and clopidogrel on early neointimal healing assessed with opticalcoherence 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) underwent3-month OCT. Differences in vascular healing patterns between the two groups, including percentage of uncovered struts on3-month OCT (9.6% vs. 11.7% in ticagrelor vs. clopidogrel, respectively; p=0.867), neointimal thickness, percentage of malapposedstruts, and healing scores did not reach statistical significance. The predictors of uncovered strut on 3-month OCT includedgreater 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.
Abstract
Purpose: This study aimed to compare the effects of ticagrelor and clopidogrel on early neointimal healing assessed with opticalcoherence 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) underwent3-month OCT. Differences in vascular healing patterns between the two groups, including percentage of uncovered struts on3-month OCT (9.6% vs. 11.7% in ticagrelor vs. clopidogrel, respectively; p=0.867), neointimal thickness, percentage of malapposedstruts, and healing scores did not reach statistical significance. The predictors of uncovered strut on 3-month OCT includedgreater 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.
참고문헌 (25)
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