Author + information
- Received May 24, 2017
- Revision received July 26, 2017
- Accepted July 26, 2017
- Published online September 18, 2017.
- Kyohei Yamaji, MD, PhDa,
- Salvatore Brugaletta, MD, PhDb,
- Manel Sabaté, MD, PhDb,
- Andrés Iñiguez, MD, PhDc,
- Lisette Okkels Jensen, MD, DMSci, PhDd,
- Angel Cequier, MD, PhDe,
- Sjoerd H. Hofma, MD, PhDf,
- Evald Høj Christiansen, MD, PhDg,
- Maarten Suttorp, MD, PhDh,
- Gerrit Anne van Es, PhDi,j,
- Yohei Sotomi, MD, PhDk,
- Yoshinobu Onuma, MD, PhDi,l,
- Patrick W. Serruys, MD, PhDm,
- Stephan Windecker, MDa,∗ ( and )
- Lorenz Räber, MD, PhDa
- aDepartment of Cardiology, Bern University Hospital, Bern, Switzerland
- bThorax Institute, University Hospital Clinic, Institut d’Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
- cHospital Álvaro Cunqueiro, Vigo, Spain
- dOdense University Hospital, Odense, Denmark
- eBellvitge University Hospital, Barcelona, Spain
- fMedical Center Leeuwarden, Leeuwarden, the Netherlands
- gAarhus University Hospital, Skejby, Denmark
- hSt Antonius Hospital, Nieuwegein, the Netherlands
- iCardialysis B.V., Rotterdam, the Netherlands
- jEuropean Cardiovascular Research Institute, Rotterdam, the Netherlands
- kThe Heart Center, Academic Medical Center, Amsterdam, the Netherlands
- lThorax Centre, Erasmus MC, Rotterdam, the Netherlands
- mInternational Center for Circulatory Health, NHLI, Imperial College, London, United Kingdom
- ↵∗Address for correspondence:
Dr. Stephan Windecker, Department of Cardiology, Bern University Hospital, Inselspital, Freiburgstrasse, 3010 Bern, Switzerland.
Objectives This study sought to investigate the effect of post-dilatation on angiographic and intracoronary imaging parameters in the setting of primary percutaneous coronary intervention comparing the everolimus-eluting bioresorbable scaffold (BRS) with the everolimus-eluting metallic stent (EES).
Background Routine post-dilatation of BRS has been suggested to improve post-procedural angiographic and subsequent device-related clinical outcomes.
Methods In the ABSORB STEMI TROFI II trial, 191 patients with ST-segment elevation myocardial infarction were randomly assigned to treatment with BRS (n = 95) or EES (n = 96). Minimal lumen area and healing score as assessed by optical coherence tomography at 6 months were compared between BRS- and EES-treated patients stratified according to post-dilatation status.
Results Primary percutaneous coronary intervention with post-dilatation was performed in 48 (50.5%) BRS- and 25 (25.5%) EES-treated lesions. There were no differences in baseline characteristics and post-procedural minimal lumen diameter between groups. In the BRS group, lesions with post-dilatation were associated with a trend toward a smaller minimal lumen area at 6 months (5.07 ± 1.68 mm2 vs. 5.72 ± 1.77 mm2; p = 0.09) and significantly larger angiographic late lumen loss (0.28 ± 0.34 mm vs. 0.12 ± 0.25 mm; p = 0.02), whereas no difference was observed in the EES arm (5.46 ± 2.18 mm2 vs. 5.55 ± 1.77 mm2; p = 0.85). The neointimal healing score was low and comparable between groups with and without post-dilation (BRS: 1.55 ± 2.61 vs. 1.92 ± 2.17; p = 0.48; EES: 2.50 ± 3.33 vs. 2.90 ± 4.80; p = 0.72).
Conclusions In the setting of selected patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention with BRS or EES, post-dilatation did not translate into larger lumen area or improved arterial healing at follow-up. (ABSORB STEMI: The TROFI II; NCT01986803)
- bioresorbable vascular scaffold
- optical coherence tomography
- percutaneous coronary intervention
- ST-segment elevation myocardial infarction
This work was sponsored by the European Cardiovascular Research Institute and received grant support from Abbott Vascular and Terumo Europe N.V. Dr. Brugaletta has received speaker fees from Abbott; and an institutional grant from AstraZeneca. Dr. Sabaté has received a consultant/speaker fee from Abbott Vascular. Dr. Jensen has received institutional research grants from Terumo, Biosensors, Biotronik, and St. Jude Medical. Dr. Cequier has received research grants from Abbott Vascular, Medtronic, Biomenco, and Spanish Society; and consulting or lectures fees from Abbott Vascular, Medtronic, and Boston Scientific. Dr. Christiansen has received institutional research grants from Biosensors, Biotronik, Abbott Vascular, Reva Medical, Boston Scientific, and Elixir; and speaker fees from OrbusNeich, Boston Scientific, Terumo, and Abbott Vascular. Dr. Sotomi is a consultant for Goodman; and has received a grant from Fukuda Memorial Foundation for Medical Research and SUNRISE laboratory. Dr. Onuma is a member of the advisory board of Abbott Vascular. Dr. Serruys is a member of the advisory board of Abbott Vascular. Dr. Windecker has received institutional research grants from Abbott, Boston Scientific, Biosensors, Biotronik, Edwards Lifesciences, Medtronic, Terumo, and St. Jude Medical; and speaker fees from AstraZeneca, Bayer, Eli Lilly, Abbott, Boston Scientific, Biosensors, Biotronik, Edwards Lifesciences, Medtronic, and St. Jude Medical. Dr. Räber has received speaker fees and institutional research grants from Abbott, Biotronik, Sanofi, and Regeneron. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received May 24, 2017.
- Revision received July 26, 2017.
- Accepted July 26, 2017.
- 2017 American College of Cardiology Foundation