Thrombogenicity of Platinum–Chromium Everolimus- Eluting Stent Is Comparably Low to That of Cobalt– Chromium Everolimus-Eluting Stent in the Subacute Phase of Acute Myocardial Infarction

• Published in: Angioscopy Vol. 6; no. 1; pp. 4 - 9
• Main Authors: Tsujimura, Takuya, Mano, Toshiaki, Ishihara, Takayuki, Okuno, Shota, Iida, Osamu, Asai, Mitsutoshi, Okamoto, Shin, Masuda, Masaharu, Kanda, Takashi, Nanto, Kiyonori, Uematsu, Masaaki
• Format: Journal Article
• Language: English
• Published: Japanese Association of Cardioangioscopy 2020
• Subjects: acute myocardial infarction; angioscopy; cobalt–chromium everolimus-eluting stent; platinum–chromium everolimus-eluting stent
• ISSN: 2188-6571; 2188-7500
• DOI: 10.15791/angioscopy.oa.20.0030

Background: Population science has shown similar outcomes between cobalt–chromium everolimus-eluting stent (CoCr-EES) and platinum–chromium everolimus-eluting stent (PtCr-EES). However, subclinical intracoronary thrombus following implantation of CoCr-EES or PtCr-EES in acute myocardial infarction (AMI) has not been explored.Methods: We performed coronary angioscopy (CAS) 13 ± 2 days after stent implantation: 47 stents in 46 lesions from 42 patients with AMI (male 90%, mean age 64 ± 13 years). The degree of thrombus adhesion and yellow plaque severity were compared between CoCr-EES (26 stents from 22 patients) and PtCr-EES (21 stents from 20 patients). The degree of thrombus adhesion was graded: grade 0 (none), no thrombus; grade 1 (focal), several spotty thrombi; grade 2 (diffuse), thrombus extending between the struts. Yellow plaque severity was graded: grade 0, white; grade 1, light yellow; grade 2, yellow; grade 3, intensive yellow.Results: Thrombus grade was similar (CoCr-EES: grade 0, 4%; grade 1, 50%; grade 2, 46%; PtCr-EES: grade 0, 19%; grade 1, 38%; grade 2, 43%, P = 0.46). Yellows plaque grade was also similar between CoCr-EES (grade 0, 0%; grade 1, 23%; grade 2, 19%; grade 3, 58%) and PtCr-EES (grade 0, 0%; grade 1, 19%; grade 2, 29%; grade 3, 52%, P = 0.88).Conclusions: Extent of subclinical intracoronary thrombus was comparable between CoCr-EES and PtCr-EES in the subacute phase of AMI, associated with equally severe yellow plaque lesions. Thrombogenicity of PtCr-EES may be similarly low to that of CoCr-EES in patients with AMI.