Reduction of in-stent thrombus immediately after percutaneous coronary intervention by pretreatment with prasugrel compared with clopidogrel: An optical coherence tomography study

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• 作者：Takashi Kubo ; MD ; PhD ; FJCC ; ^{takakubo@wakayama-med.ac.jp} ; Yasushi Ino ; MD ; PhD ; Yoshiki Matsuo ; MD ; PhD ; Yasutsugu Shiono ; MD ; PhD ; Takeyoshi Kameyama ; MD ; PhD ; Takashi Yamano ; MD ; PhD ; Yosuke Katayama ; MD ; Akira Taruya ; MD ; Tsuyoshi Nishiguchi ; MD ; Keisuke Satogami ; MD ; Kuninobu Kashiyama ; MD ; PhD ; Makoto Orii ; MD ; PhD ; Akio Kuroi ; MD ; PhD ; Tomoyuki Yamaguchi ; MD ; Atsushi Tanaka ; MD ; PhD ; Takeshi Hozumi ; MD ; PhD ; Takashi Akasaka ; MD ; PhD ; FJCC
• 关键词：Acute coronary syndrome ; Optical coherence tomography ; Prasugrel ; Stent ; Thrombus
• 刊名：Journal of Cardiology
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：69
• 期：2
• 页码：436-441
• 全文大小：651 K
• 卷排序：69

文摘

Prasugrel is a new-generation thienopyridine antiplatelet agent that provides more consistent and prompt platelet inhibition than clopidogrel. The aim of this study was to compare in-stent thrombus inhibition effect of pretreatment with prasugrel and clopidogrel by using optical coherence tomography (OCT) immediately after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS).MethodsWe performed OCT immediately after PCI in 108 ACS patients pretreated with either prasugrel (n = 51) or clopidogrel (n = 57). OCT detected thrombus/plaque protrusion in all stented segments.ResultsAlthough stent volume (190.4 ± 119.1 mm3 vs. 189.4 ± 95.8 mm3, p = 0.961), mean stent area (6.9 ± 2.9 mm2 vs. 7.1 ± 2.0 mm2, p = 0.772), and minimum stent area (5.6 ± 2.7 mm2 vs. 5.4 ± 1.7 mm2, p = 0.554) were not different between the two groups, in-stent thrombus/plaque protrusion volume (1.8 ± 2.9 mm3 vs. 4.5 ± 5.3 mm3, p = 0.002), mean in-stent thrombus/plaque protrusion area (0.1 ± 0.1 mm2 vs. 0.2 ± 0.2 mm2, p = 0.005), and maximum in-stent thrombus/plaque protrusion area (0.5 ± 0.7 mm2 vs. 0.8 ± 0.6 mm2, p = 0.007) were significantly smaller in the prasugrel group compared with the clopidogrel group.ConclusionsPretreatment with prasugrel was associated with significantly reduced in-stent thrombus/plaque protrusion immediately after PCI for ACS compared with that with clopidogrel.