Academic Journal
A randomized prospective study investigating the relationship between post-PCI wall shear stress and 12-month neointimal healing: The SHEAR-STENT study.
| Τίτλος: | A randomized prospective study investigating the relationship between post-PCI wall shear stress and 12-month neointimal healing: The SHEAR-STENT study. |
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| Συγγραφείς: | Molony DS; Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA., Hung O; Division of Cardiology, Emory University, Atlanta, GA, USA., Corban M; Division of Cardiology, Emory University, Atlanta, GA, USA., Gogas B; Division of Cardiology, Emory University, Atlanta, GA, USA., Lefieux A; Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA., Shah I; Department of Biomedical Engineering, Georgia Institute of Technology, GA, USA; Department of Mathematics and Computer Science, Emory University, Atlanta, GA, USA., Komilian K; Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA., Adams A; Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA., Sykalo C; Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA., Dodoo S; Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA., Kumar A; Division of Cardiology, Emory University, Atlanta, GA, USA., Kumar S; Division of Cardiology, Emory University, Atlanta, GA, USA., Azarnoosh J; Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA., Piccinelli M; Division of Cardiology, Emory University, Atlanta, GA, USA., McDaniel MC; Division of Cardiology, Emory University, Atlanta, GA, USA., King SB; Division of Cardiology, Emory University, Atlanta, GA, USA., Maynard C; Department of Health Services, University of Washington, Seattle, USA., Chatzizisis YS; Division of Cardiovascular Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA., Chen SL; Nanjing First Hospital, Nanjing Medical University, China., Shin ES; Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea., Stankovic G; Department of Cardiology, University Clinical Center of Serbia, Belgrade, Serbia., Milasinovic D; Department of Cardiology, University Clinical Center of Serbia, Belgrade, Serbia., Erglis A; Pauls Stradins Clinical University Hospital, University of Latvia, Riga, Latvia., Otake H; Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan., Akasaka T; Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan., Escaned J; Department of Cardiology, Hospital Clínico San Carlos, Madrid, Spain., Kwon-Koo B; Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea., Wook-Nam C; Department of Cardiology, Chung-Ang University Gwangmyeong Medical Center, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea., Won KB; Department of Cardiology, Chung-Ang University Gwangmyeong Medical Center, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea., Murasato Y; Department of Cardiology and Clinical Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan., Lee WY; Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea., Lee SH; Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Hahn JY; Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Lee JM; Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea., Giddens DP; Department of Biomedical Engineering, Georgia Institute of Technology, GA, USA., Veneziani A; Department of Mathematics and Computer Science, Emory University, Atlanta, GA, USA., Samady H; Division of Cardiology, Emory University, Atlanta, GA, USA. Electronic address: habib.samady@gmail.com. |
| Πηγή: | Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2026 Jul; Vol. 88, pp. 57-65. Date of Electronic Publication: 2025 Nov 15. |
| Τύπος έκδοσης: | Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: United States NLM ID: 101238551 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-0938 (Electronic) Linking ISSN: 18780938 NLM ISO Abbreviation: Cardiovasc Revasc Med Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: New York, NY : Elsevier, c2005- |
| Ιατρικοί όροι (MeSH): | Coronary Artery Disease*/diagnostic imaging , Coronary Artery Disease*/therapy , Coronary Artery Disease*/physiopathology , Percutaneous Coronary Intervention*/adverse effects , Percutaneous Coronary Intervention*/instrumentation , Coronary Vessels*/diagnostic imaging , Coronary Vessels*/physiopathology , Coronary Vessels*/pathology , Neointima* , Drug-Eluting Stents* , Wound Healing*, Humans ; Male ; Female ; Prospective Studies ; Middle Aged ; Stress, Mechanical ; Time Factors ; Aged ; Tomography, Optical Coherence ; Treatment Outcome ; Coronary Angiography ; Prosthesis Design |
| Περίληψη: | Background: While disturbed wall shear stress (WSS) is associated with coronary plaque progression and vulnerability, its influence on stent neointimal healing is not well characterized. We designed a prospective, randomized trial to investigate the influence of WSS on neointimal healing in angulated arteries undergoing percutaneous coronary intervention (PCI). Methods: Eighty-six patients were randomized to Xience Xpedition® (X-EES) or Resolute® Integrity/Onyx (R-ZES) drug-eluting stents. Patients underwent serial OCT imaging post PCI and at 12-months. Angiography was combined with OCT to generate post-stent vessel reconstructions. WSS was calculated using computational fluid dynamics. Post-stent WSS was related to strut, frame and patient level neointimal thickness (NIT) at 12-months. Results: Sixty patients met inclusion criteria and had adequate OCT image quality for analysis. Mean age was 62.7 years, 78 % were men, and 37 % had diabetes. NIT at 12-months was 0.09 mm (0.05-0.15). There was no difference in frame level NIT (p = 0.08) or post-stent WSS (p = 0.75) between X-EES or R-ZES. Patient level analysis demonstrated correlation coefficients between WSS and NIT ranging from -0.78 to 0.67. Of these, 33 % were significantly positive, indicating an association between high WSS and increased NIT, while 31.6 % were significantly negative signifying an association between low WSS and increased NIT. Age, gender, hyperlipidemia, diabetes, renal insufficiency or prior MI was not associated with the distribution of correlation coefficients. Conclusions: The SHEAR-STENT study demonstrated no significant differences in WSS or NIT at 12 months between R-ZES and X-EES. A wide range of patient level correlation coefficients between WSS and NIT were observed, with some patients showing increased NIT was associated with low WSS and others associated with high WSS. Registration: URL: https://www. Clinicaltrials: gov; Unique identifier: NCT02098876. (Copyright © 2025 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of competing interest Dr. Samady has the following relationships with industry to disclose: advisory board of Phillips Volcano, institutional research grants with Philips Volcano, Medtronic and Abbott Vascular, equity ownership and co-founder of Covanos Inc. Dr. Molony has equity ownership in Covanos Inc. Dr. J.M. Lee has received research grants from Abbott and Philips. Dr. Koo has received institutional research grants from Abbott Vascular and Philips Volcano. Dr. Chatzizisis has received speaker honoraria, advisory board fees, and research grants from Boston Scientific; advisory board fees and research grants from Medtronic Inc. Dr. Escaned has received speaker and/or advisory board member fees from Abbott Vascular, Boston Scientific, Medis, and Philips. Dr. Stankovic has received speaker honoraria from Abbott Vascular, Boston Scientific and Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. |
| Contributed Indexing: | Keywords: Coronary; Neointima; Stent; Wall shear stress |
| Molecular Sequence: | ClinicalTrials.gov NCT02098876 |
| Entry Date(s): | Date Created: 20251124 Date Completed: 20260707 Latest Revision: 20260728 |
| Update Code: | 20260728 |
| DOI: | 10.1016/j.carrev.2025.11.001 |
| PMID: | 41285658 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1878-0938 |
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| DOI: | 10.1016/j.carrev.2025.11.001 |