Background:Second-generation drug-eluting stents (DES) reduce the incidence of stent thrombosis, even in patients with ST-segment elevated myocardial infarction (STEMI). However, the early local vascular healing after DES implantation in STEMI lesions, which mainly concerns stent thrombosis, is still unclear.

Methods and Results:We attempted to determine early local vascular healing 3 months after cobalt–chromium everolimus-eluting stent (CoCr-EES) implantation in STEMI lesions relative to stable coronary artery disease (CAD) lesions. This prospective, multicenter study analyzed 96 total lesions (STEMI=49, stable CAD=51) by frequency domain-optical coherence tomography (FD-OCT) performed post-procedure and at the 3-month follow-up. Although CoCr-EES implanted in STEMI were almost entirely covered at 3 months, they had a relatively high incidence of uncovered struts compared with stable CAD (5.5% vs. 1.6%, P<0.001). Intrastent thrombus in the 2 groups was primarily resolved at the 3-month follow-up (STEMI: 91.7%→26.5%, stable CAD: 74.5%→11.8%). Regarding irregular protrusion, complete resolution was observed in stable CAD (21.6%→0%), while a few stents remained in STEMI (79.2%→8.2%). Although there were almost no changes for the serial change of average lumen area in STEMI, there were slight but significant decreases in stable CAD [STEMI 0.08 (−0.44, 0.55) mm², stable CAD −0.35 (−0.55, 0.11) mm²; P=0.009].

Conclusions:Although strut coverage after CoCr-EES implantation for STEMI lesions was slightly delayed, the healing process appeared to be acceptable in both STEMI and stable CAD.

背景：第二代药物洗脱支架 (DES) 降低了支架血栓的发生率，即使在 ST 段抬高型心肌梗死 (STEMI) 患者中也是如此。然而，主要涉及支架血栓形成的STEMI病变中DES植入后的早期局部血管愈合尚不清楚。

方法和结果：我们试图确定相对于稳定型冠状动脉疾病 (CAD) 病变的 STEMI 病变中钴铬依维莫司洗脱支架 (CoCr-EES) 植入后 3 个月的早期局部血管愈合情况。这项前瞻性、多中心研究通过在手术后和 3 个月的随访中进行的频域光学相干断层扫描 (FD-OCT) 分析了 96 个总病变（STEMI=49，稳定 CAD=51）。尽管植入 STEMI 的 CoCr-EES 在 3 个月时几乎完全被覆盖，但与稳定的 CAD 相比，它们的未覆盖支柱发生率相对较高（5.5% 对 1.6%，P<0.001）。3个月随访时2组支架内血栓均基本消退（STEMI：91.7%→26.5%，稳定CAD：74.5%→11.8%）。对于不规则突出，在稳定的CAD中观察到完全分辨率（21.6%→0%），而少数支架留在 STEMI 中（79.2%→8.2%）。虽然 STEMI 平均管腔面积的连续变化几乎没有变化，但稳定 CAD [STEMI 0.08 (-0.44, 0.55) mm 有轻微但显着的下降²、稳定的CAD -0.35 (-0.55, 0.11) mm ²；P=0.009]。

结论：虽然植入 CoCr-EES 治疗 STEMI 病变后的支柱覆盖率略有延迟，但 STEMI 和稳定型 CAD 的愈合过程似乎是可以接受的。