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01-02-2021 | Clopidogrel | Original Article

Impact of antiplatelet therapy on tissue prolapse at super acute phase after stenting: serial OCT study in acute coronary syndrome patients

Authors: Kazuhiro Naito, Yusuke Nakano, Katsuhisa Waseda, Hiroaki Takashima, Hirohiko Ando, Shinichiro Sakurai, Akihiro Suzuki, Yuki Saka, Hiroaki Sawada, Shigeko Nagahiro, Mayu Suzuki, Masahiro Shimoda, Tetsuya Amano

Published in: Heart and Vessels | Issue 2/2021

Abstract

Although drug-eluting stents have improved clinical outcomes, percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) remains a challenging procedure in terms of thrombus management. A new-generation P2Y12 receptor inhibitor, prasugrel, provides more rapid and potent antiplatelet action compared with clopidogrel. Prasugrel achieved significant reduction of ischemic events compared with clopidogrel in ACS. The aim of this optical coherence tomography (OCT) study was to evaluate temporal changes in tissue prolapse after stenting under different antiplatelet regimens (aspirin plus prasugrel or clopidogrel) in ACS patients. A total of 119 ACS patients were randomized to either prasugrel or clopidogrel at the time of PCI. OCT analysis was available in 119 patients at baseline (just after stenting), 77 patients at 2 weeks, and 62 patients at 4 months after stenting. Cross-sectional analysis for every 1 mm was performed at in-stent and adjacent reference segment. Tissue prolapse area was calculated by lumen area minus stent area within the stented segment. Baseline patient and procedural characteristics were not different between the prasugrel and clopidogrel groups. Tissue prolapse area was significantly lower in the prasugrel compared with the clopidogrel group after stenting (0.24 ± 0.23 vs. 0.36 ± 0.23 mm², p = 0.003) and at 2 weeks (0.11 ± 0.13 vs. 0.19 ± 0.16 mm², p = 0.005). However, there was no significant difference at 4 months. In conclusion, our study suggests prasugrel was effective in reducing tissue prolapse in the super acute phase in ACS patients compared with clopidogrel. However, the effect of tissue prolapse reduction was not different up to 4 months follow-up.

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Title: Impact of antiplatelet therapy on tissue prolapse at super acute phase after stenting: serial OCT study in acute coronary syndrome patients
Authors: Kazuhiro Naito
Yusuke Nakano
Katsuhisa Waseda
Hiroaki Takashima
Hirohiko Ando
Shinichiro Sakurai
Akihiro Suzuki
Yuki Saka
Hiroaki Sawada
Shigeko Nagahiro
Mayu Suzuki
Masahiro Shimoda
Tetsuya Amano
Publication date: 01-02-2021
Publisher: Springer Japan
Keywords: Clopidogrel
Acute Coronary Syndrome
Prasugrel
Published in: Heart and Vessels / Issue 2/2021
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-020-01686-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of antiplatelet therapy on tissue prolapse at super acute phase after stenting: serial OCT study in acute coronary syndrome patients

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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