Randomized comparison of dexamethasone-eluting stents with bare metal stent implantation in patients with acute coronary syndrome: Serial angiographic and sonographic analysis

• Published in: The American heart journal 2007-06, Vol.153 (6), p.979.e1-979.e8
• Main Authors: König, Andreas, MD, Leibig, Markus, MD, Rieber, Johannes, MD, Schiele, Thomas Michael, MD, Theisen, Karl, MD, Siebert, Uwe, MD, Gothe, Raffaella Matteucci, MD, Klauss, Volker, MD
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Angioplasty; Cardiovascular; Coated Materials, Biocompatible; Coronary Angiography; Coronary Disease - diagnosis; Coronary Disease - diagnostic imaging; Coronary Disease - therapy; Coronary vessels; Coronary Vessels - diagnostic imaging; Dexamethasone - administration & dosage; Drug Implants; Female; Follow-Up Studies; Heart attacks; Humans; Male; Middle Aged; Stents; Stents - classification; Syndrome; Treatment Outcome; Ultrasonography, Interventional
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2007.03.032

Aims The aim of this study is to compare the anti-inflammatory effect of the dexamethasone preloaded stent (Dexamet, Abbott, Galway, Ireland) with the bare metal stent (BMS; BiodivYsio, Biocompatibles Cardiovascular LTD, Galway, Ireland) in patients with acute coronary syndrome (ACS) assessed by angiographic (QCA) and intracoronary ultrasound (ICUS). Methods and Results One hundred twenty patients with ACS were randomly assigned to revascularization using the Dexamet stent (n = 60) or BMS (n = 60). Serial QCA analysis and ICUS analysis were performed during long-term follow-up (2.9 F; 20 MHz transducer; Volcano Corp, Brussels, Belgium). Power calculations were performed for QCA-derived differences of lumen loss. In addition, statistical analysis was performed (SPSS for Windows 12.0.1). The target lesion revascularization rate was lower in the Dexamet group (10 [16.67%] vs 20 [33.33%] patients; P = .031). The QCA revealed improved lumen restoration in the Dexamet stent group (lumen loss, 0.55 ± 0.65 vs 1.07 ± 0.92 mm [ P = .001]; loss index, 0.20 ± 0.23 vs 0.46 ± 0.42 [ P < .001]). The ICUS revealed greater neointimal proliferation in the BMS versus the Dexamet stent group (3.36 ± 1.03 vs 3.05 ± 1.38 mm2 ; P < .001). Death (n = 1) and the number of total occlusions of the stent segment (n = 1) were identical in both groups. Conclusion Dexamet stents, in comparison with the BMS stents, reduced the target lesion revascularization rate in patients with ACS and lead to better lumen restoration during long-term follow-up.