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KMID : 0311120180590050624
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Yonsei Medical Journal
2018 Volume.59 No. 5 p.624 ~ p.632
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Randomized Comparison of Strut Coverage between Ticagrelor and Clopidogrel in Acute Myocardial Infarction at 3-Month Optical Coherence Tomography
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Kim Choong-Ki
Kim Byeong-Keuk
Hong Sung-Jin
Ahn Chul-Min
Kim Jung-Sun
Ko Young-Guk
Choi Dong-Hoon
Hong Myeong-Ki
Jang Yang-Soo
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Abstract
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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.
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KEYWORD
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Neointima, tomography, optical coherence, myocardial infarction, ticagrelor, clopidogrel
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