It is of concern that women are more likely to undergo fewer diagnostic tests and receive less treatment for acute myocardial infarction (AMI) than men. However, it is still unclear whether gender differences exist according to age groups. Therefore, we studied the influence of gender on the delivery of cardiac management according to two age groups (< 65, ≥ 65) in Japan. Data from the Tokai Acute Myocardial Infarction Study (TAMIS) sample were used. This is a retrospective study of all consecutive patients admitted to the 13 acute care hospitals in the Tokai region of Japan, which includes Aichi and Shizuoka Prefectures, with a diagnosis of AMI from 1995 to 1997. A total of 143 younger women, 822 younger men, 391 older women, and 611 older men were included. Information concerning patient demographics, in-hospital course, comorbid conditions, electrocardiography (ECG), ultrasound-echocardiography (UCG), treadmill test (TMT), coronary angiography (CAG), percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass graft (CABG), intra-aortic balloon pump (IABP), mechanical ventilation, and in-hospital or discharge medication (thrombolytics, vasopressors, aspirin, β-blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium antagonists, nitrates) were collected. Among the young, after controlling for these baseline variables, women were significantly less likely to undergo PTCA compared to men (OR, 0.54, 95%CI, 0.35-0.82). After controlling for these baseline variables, only lipid-lowering therapy tended to be more frequent in women than in men among the elderly (OR, 2.79, 95%CI, 1.47-2.58). The findings suggest that younger women with AMI are less likely than younger men to undergo PTCA, and that older women with AMI are more likely to receive lipid-lowering therapy.

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The aims of the present study were to analyze cardiac collagen metabolism changes in vivo during acute and nonacute phases of ST elevation myocardial infarction (STEMI) in patients who were treated with primary coronary intervention (PCI) only, and to determine the predictive significance of collagen I and III synthesis markers (PICP, PIIINP) as well as the collagen I degradation marker (ICTP) on left ventricular function and volume changes after STEMI. Serum levels of the carboxy-terminal propeptide of type I procollagen (PICP) and amino-terminal propeptide of type III procollagen (PIIINP) assessed on the 30th day and the carboxyterminal telopeptide located at the C end of collagen type I (ICTP) assessed on the 7th day after STEMI were significantly higher (P = 0.01, P = 0.019, P = 0.04, respectively) in the PCI unsuccessful group than in the PCI successful group. These findings support the theory that early and successful PCI not only limits the amount of muscle necrosis but also protects cardiac collagen from ischemia-related injury. PICP and PIIINP levels assessed on the fourth day after acute STEMI enables us to predict the development of left ventricular function (EF) and end-diastolic volume changes over the course of 6 months, irrespective of the initial EF or revascularization success.

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The aim of this study was to investigate the correlation between ECG changes prior to discharge and findings of early low dose dobutamine stress echocardiography (LDSE) performed in 6 ± 2 days, in patients experiencing their first acute anterior MI.
A total of 62 patients admitted with their first acute anterior MI were divided into three groups according to the findings of electrocardiograms performed on the 7-10th days: group A, isoelectric ST and negative or positive T wave; group B, ST elevation (> 0.1 mV) and negative T wave; and group C, ST elevation and positive T wave.
There were no significant differences between the groups with respect to thrombolytic therapy and reperfusion criteria. In addition, 90% of the patients in group A (20/22), 66% in group B (12/18, P < 0.05 versus group A), and only 54% in group C (12/22, P < 0.01 versus group A) responded to LDSE. The infarct zone wall motion score index (WMSI) measured by LDSE was significantly decreased in group A compared to basal values (from 2.71 ± 0.65 to 2.07 ± 0.71 P = 0.02), and it was significantly different compared to groups B and C. Moreover, the serum creatinine kinase level of the patients in group C was higher (P < 0.01 versus group A), whereas the ejection fraction was inferior (group A 48%, group B 47%, and group C 41%, P = 0.04 versus group A). When the correlations between good left ventricular function and terminal QRS distortion, sum ST elevation, the number of leads with ST elevation, ST elevation shape on admission, and ST and T alterations in ECG at discharge were investigated, an independent correlation was found between ST and T alteration in ECG and a WMSI value < 2 at rest or after LDSE (P = 0.03, OR 3.08, 95%CI 1.05-8.98).
At the infarct zone of patients with ST elevation and positive T waves, left ventricular function is worse and the viability is less. This simple classification may be useful in predicting left ventricular function at the time of discharge.

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Relative increases in unsaturated fatty acids (USFA) in the diet are considered to exert beneficial effects on coronary risk factors (CRF). However, detailed analysis of the relationships between serum USFA and CRF are scanty and there is no report of the relationship between nervonic acid (NA) and CRF. The objective of the present study was to analyze the relationships between serum USFA and CRF.
Body height and weight, blood pressure, fasting serum total cholesterol (TC), triacyl-glycerol (TG), HDL cholesterol (HDLc), fasting blood sugar (FBS), total fatty acid composition, leptin, and high-sensitivity C-reactive protein (CRP) were measured in 31 men (age, 41-78 years) and 11 women (age, 54-77 years). The relationships between serum USFA, and body mass index (BMI), leptin, systolic blood pressure (SBP), diastolic blood pressure (DBP), TC, TG, HDLc, FBS, and CRP were analyzed using multiple regression analysis. The final results were summarized using coronary risk factor scores (CRFS) in order to assess the correlations between USFA with CRF.
Oleic acid (OA), linoleic acid (LA), and eicosapentaenoic acid (EPA) were positively related to coronary risk factors (total CRFS = 2, 3, and 4, respectively), while nervonic acid (NA) exerted negative effects on these risk factors (total CRFS = −6 ). It is concluded NA may have preventive effects on obesity-related metabolic disorders.

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Hydroxymethyglutaryl coenzyme A reductase inhibition (statin) therapy has been shown to reduce cardiac hypertrophy in vitro and in vivo. We assessed the influence of short-term statin therapy on left ventricular (LV) remodeling after acute myocardial in-farction. Thirty-five patients with first anterior acute myocardial infarction, who underwent primary coronary angioplasty within 12 hours of onset, were divided into 2 groups. Ten patients taking statin served as the statin group, and 25 patients not taking statin served as the control group. Two-dimensional echocardiography was recorded after angioplasty (baseline) and at 4 weeks. LV ejection fraction (LVEF) at baseline was not significantly different between the 2 groups. However, the statin group had a higher LVEF at 4 weeks than the control group (58.2 ± 5.0 versus 49.0 ± 12.7%; P < 0.05). Moreover, the increase in LV end-diastolic volume (LVEDV) at 4 weeks was lower in the statin group than in the control group (12.1 ± 29.6 versus 39.9 ± 35.7 mL; P < 0.05). Multiple regression analysis demonstrated that administration of statin was an independent factor for the increase in LVEDV (P < 0.05). These findings indicate that short-term statin therapy can prevent postinfarct LV remodeling and improve LV function.

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The flexibility of the Multi-Link (ML) PENTA stent with platform 0.09 to 0.12-mm-thick struts and 12% to 16% metal/artery coverage was improved to facilitate safe delivery in complex coronary lesions. The present study was designed to evaluate the clinical (9-month) and angiographic (6-month) results of the ML PENTA stent in complex coronary lesions (modified American College of Cardiology/American Heart Association lesion type B2 or C) and to determine independent factors correlated with target lesion revascularization. The study population consisted of 86 consecutive patients who had undergone successful coronary ML PENTA stent implantation for coronary artery disease from May 2003 to July 2004 in our hospital. During the follow-up period, cardiac events were documented in 21 (24.4%) of the 86 patients. Target lesion revascularization was required in 16 (18.6%) of the 86 patients. Single logistic regression analysis showed that target lesion revascularization was significantly correlated with lesion length > 2.0 cm, residual percent diameter stenosis after the procedure > 20%, and multiple stents. Multiple logistic regression analysis showed that residual percent diameter stenosis after procedure > 20% (P = 0.0125, odds ratio = 11.585) was the significant explanatory factor of target lesion revascularization. The results of the present study suggest that 9-month clinical and 6-month angiographic outcomes in patients with coronary artery disease treated using the ML PENTA stent were excellent and target lesion revascularization after coronary ML PENTA stent implantation was influenced by residual percent diameter stenosis after the procedure.

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While the usefulness of measuring the plasma levels of brain natriuretic peptide (BNP) in cases with worsening heart failure and severe heart failure has already been established, the benefits of evaluation of this parameter in asymptomatic stable patients with left ventricular dysfunction is still under debate. Left ventricular function was evaluated in 141 ambulatory outpatients with a previous history of myocardial infarction not associated with symptoms of heart failure for at least one year. The plasma BNP level was also determined in these patients for comparative study. No correlation between the plasma level of BNP and EF was noted in the normal-EF group, while a negative correlation between the two parameters was observed in the low-EF group (Y = 0.439 - 0.000266X) (R2 = 0.244, P < 0.0001). The sensitivity was 91.5%, specificity 56.3%, positive predictive accuracy value 61.9%, and negative predictive accuracy value 83.8% for a plasma BNP cut-off level of 89.0 pg/mL.
The results suggested that it might be meaningful to measure the plasma BNP level, especially in asymptomatic patients with a previous history of myocardial infarction having a low-EF.

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This article was retracted. See the Notification.

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Radiofrequency catheter ablation or modification of the slow pathway is almost always performed on the right atrial side of the interatrial septum, however, this is not possible in rare cases. We evaluated the clinical and electrophysiological characteristics and long-term follow-up results of patients whose AVNRT could only be ablated from the left posterior atrial septum after repeated unsuccessful attempts on the right atrial side and to observe if they differ from those undergoing ablation with the conventional right-sided approach.
Of 587 cases with symptomatic typical AVNRT, 9 patients (1.5%) in whom RF energy delivered to the right atrial septum with the integrated approach failed to ablate or modify the slow pathway were enrolled in the study group (group 1) while the others served as controls (group 2). There was no significant difference between the groups regarding clinical characteristics, dual AV nodal physiology, sinus cycle lengths, AH and HV intervals, procedural complication rates, or recurrence rates in the mean follow-up duration of 34 ± 11 months. Only tachycardia cycle length (TCL) was significantly higher in group 1 than in group 2, which was mainly due to the difference in AH intervals (P < 0.001 for both). Slow pathway ablation was performed at the posteroseptal aspect of the mitral annulus in 6 and the midseptal aspect in 2 cases. In 1 case, attempts at ablation on the left atrial septum also failed.
When the conventional right-sided approach fails to ablate or modify the slow pathway conduction, left-sided ablation can safely and effectively be employed, with success rates and long-term follow-up results comparable to the conventional right-sided approach.

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Although interferon (IFN) shows cardiotoxicity and arrhythmogenesis, the influence of IFN on signal-averaged electrocardiography remains to be clarified. The aim of this study was to test a clinical hypothesis that IFN therapy for hepatitis C virus may induce ventricular late potentials (LPs) and related arrhythmias in patients with chronic active hepatitis. Signal-averaged and ambulatory electrocardiograms were recorded sequentially in patients with chronic active hepatitis C (n = 22) throughout the entire period of IFN therapy. The filtered QRS duration (fQRS) and low amplitude (< 40 μV) signal duration (LAS40) were significantly increased (95.5 ± 8.5 to 99.6 ± 9.4 msec, P < 0.0001, and 32.8 ± 3.1 to 36.3 ± 3.0 msec, P < 0.0001, respectively), whereas the root mean square voltage in the terminal 40 msec of the fQRS (RMS40) was significantly decreased (25.5 ± 5.4 to 22.3 ± 5.2 μV, P < 0.005) 1 month after starting the IFN therapy. The ventricular LP was negative in all subjects before starting therapy, but became positive in 7 patients after the therapy commenced. There were no differences in clinical baseline characteristics between the LP-positive (n = 7) and LP-negative (n = 15) groups. Significant increases in mean heart rate, fQRS, and LAS40 were observed after starting the therapy, irrespective of the appearance of the ventricular LP, whereas a decrease in RMS40 was observed only in the LP-positive group. No sustained ventricular arrhythmias were documented in the ambulatory electrocardiography and no cardiac events were encountered in the follow-up period. Therefore, the results indicate a reversible and subclinical risk of IFN-induced arrhythmogenesis.

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Intraaortic balloon pumping (IABP) is a useful therapy for refractory heart failure. However, the safe duration of this therapy and possible complications due to long-term IABP support remain unclear. In this study, we reviewed retrospectively patients requiring the long-term use of IABP, defined here as 10 days or more, to estimate the background and prognosis of patients undergoing long-term use of IABP. The characteristics and perioperative status were compared between survivors and nonsurvivors.
A total of 18 patients including 12 males and 6 females required long-term IABP use. IABP was induced in 13 patients (72%) following cardiac surgery and in 5 without cardiac surgery. The mean duration of IABP support was 17 ± 7 days. Seven patients survived and 11 died of heart failure and/or associated other organ failure. Multiple organ failure (MOF) was recognized in 10 patients, and the incidence of MOF was significantly (P = 0.005) lower in the survivors (14%) compared to the nonsurvivors (82%). The percentage of postcardiac surgery patients was also significantly (P = 0.027) higher in nonsurvivors (91%) than in survivors (43%). Logistic regression analysis identified MOF and cardiac surgery as independent predictors for death. Femoral arterial-venous fistula was the only IABP-related complication. In patients receiving long-term IABP, attention should be paid to other organ complications associated with heart failure, and the use of other circulatory supports such as PCPS or VAD to avoid MOF should be considered if necessary.

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We investigated the correlations between exercise intolerance and the plasma levels of neurohormonal factors and proinflammatory cytokines in chronic heart failure (CHF) patients.
Sixty-two CHF patients who underwent cardiopulmonary exercise testing (CPX) were enrolled in this study. Peak oxygen uptake (peak VO₂) and the plasma concentrations of noradrenaline (NA), brain natriuretic peptide (BNP), and soluble tumor necrosis factor receptors I and II (TNFR-I and -II) were all measured during the CPX. The patients were divided into three groups according to their peak VO₂; a severe exercise intolerance group (severe group; peak VO₂ < 18 mL/min/kg), moderate exercise intolerance group (moderate group; 18 ≤ peak VO₂ ≤ 24), and mild exercise intolerance group (mild group; peak VO₂ > 24).
There were no significant differences in left ventricular ejection fraction (EF) among the three groups. NA and BNP both increased gradually in parallel with the worsening of exercise intolerance (NA, 211.5 ± 75.7 pg/mL, 331.8 ± 163.7, 441.9 ± 202.9, respectively; BNP, 37.9 ± 25.4 pg/mL, 148.9 ± 117.1, 247.9 ± 150.0, respectively). TNFR-I and II were significantly higher in the severe group than in the moderate group (1746.1 ± 950.7 versus 1085.2 ± 370.5 pg/mL and 2855.3 ± 1550.9 versus 2047.7 ± 648.7 pg/mL, respectively), while the values in the moderate group were not significantly different from those in the mild group. EF showed no significant correlations with NA, BNP, TNFR-I, or TNFR-II, whereas peak VO₂ exhibited significant negative correlations with NA (r = −0.50, P < 0.0001), BNP (r = −0.53, P < 0.0001), TNFR-I (r = −0.50, P < 0.0001), and TNFR-II (r = −0.45, P < 0.0001).
It is concluded that NA and BNP rise in parallel with the degree of exercise intolerance, while TNFR-I and -II rise only when exercise intolerance reaches severe levels.

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Percutaneous transluminal renal artery stenting (PTRAS) is associated with declining renal function in a non-negligible portion of patients and is inflicted by different mechanisms, including atheroembolism. This study investigated whether delicate PTRAS to reduce atheroembolism might minimize postoperative renal injury and better preserve renal function. Patients undergoing PTRAS performed by experienced interventional cardiologists, applying coronary intervention concepts, techniques, devices and delicacy principles whenever possible, were prospectively studied. A total of 34 patients (29 M/5 F) with impaired renal function (group A, creatinine 2.4 ± 0.1 mg/dL) and another 20 patients (16 M/4 F) with normal serum creatinine (group B, baseline creatinine 1.2 ± 0.0 mg/dL) were studied. PTRAS was successfully performed in all but one group A patient. During a 6-month follow-up, systolic and diastolic blood pressure (130 ± 2 versus 148 ± 4 mmHg, P = 0.001 and 70 ± 2 versus 78 ± 3 mmHg, P = 0.006) and serum creatinine (2.1 ± 0.1 versus 2.4 ± 0.1 mg/dL, P < 0.001) were all significantly lowered in group A patients. Using a 20% change cut-off value, renal function improved in eight (24%), remained unchanged in 24 patients (73%), and deteriorated in only one patient (3%). The corresponding alterations in blood pressure and renal function were insignificant in group B patients. Patients with bilateral involvement (eleven patients) also had significantly lowered serum creatinine on follow-up. In conclusion, delicately practiced PTRAS can reduce the rate of postprocedural renal deterioration in patients with impaired renal function, and should be adopted in every renal intervention.

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The aim of this study was to determine the frequency of target organ damage (TOD) and the beneficial properties of ambulatory blood pressure monitoring (ABPM) for detecting patients who are at high risk for TOD and cardiovascular disease in never treated mild-to-moderate hypertension.
Sixty-seven patients (28 males and 39 females, mean age, 49.6 ± 9.5 years) were divided into two groups, dippers (group I, n = 43) and nondippers (group II, n = 24), according to nocturnal blood pressure (BP) reduction of less than 10%. The groups were compared with respect to demographic and laboratory data and the signs of TOD (microalbuminuria, left ventricular hypertrophy, and retinopathy). We also tested the relationship between ABPM and clinic BP findings with TOD. Group I had significantly lower values than group II for serum fibrinogen (0.28 ± 0.06 versus 0.32 ± 0.06 g/L, P = 0.02), uric acid (0.18 ± 0.05 versus 0.25 ± 0.11 mmo/L, P = 0.01), urinary sodium excretion (133.7 ± 45.2 versus 161.8 ± 52.2 mmol/L, P = 0.02), urinary albumin excretion (17.5 ± 14.2 versus 31.3 ± 19.7 mg/24-h, P = 0.001), left ventricular mass index (111.8 ± 31.0 versus 128.7 ± 36.6 g/m², P = 0.05), and the prevalence of hypertensive retinopathy (51% versus 83%, P = 0.01). The frequency of the combination of all three signs of TOD (microalbuminuria, left ventricular hypertrophy, and hypertensive retinopathy) was higher in nondippers than in dippers (71.4% versus 30%, P = 0.04). We suggest ABPM may provide clinical information to detect patients prone to develop cardiovascular risks and TOD in newly diagnosed mild-to-moderate hypertension.

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The objective of the present study was to examine cases of acute aortic dissection in order to analyze the clinical and diagnostic findings, and to summarize their treatment modalities, as well as their hospital outcomes.
Between July 1998 and June 1999, we prospectively studied patients who were newly diagnosed as having acute aortic dissection at 25 hospitals in Mie prefecture. These cases were examined for their demographics, the characteristics of the clinical findings, diagnostic methods, treatment modalities according to the type of aortic dissection, and the early morbidity and mortality of the hospital outcomes.
Of 66 newly diagnosed aortic dissections (43 males), 30 were type A and 36 were type B. Seventy-six percent of the cases arrived at a medical facility within 6 hours from the onset of symptoms. Frequent initial symptoms and clinical findings were pain in 95.5%, cardiac arrest and/or hypotension in 21%, pericardial effusion in 29%, pleural effusion in 25%, and neurological signs in 30%. Twenty-one patients underwent surgical repair, 36 were treated medically, and 5 underwent endovascular stenting. Overall early mortality was 12.1%, which included 2 DOA. Fifty percent of these deaths occurred within 48 hours, and 63% by 72 hours of the initial event.
In spite of the relatively rare incidence of acute aortic dissection in our study, the calculated incidence was 4.0/100,000/year. The overall mortality rate was relatively low compared to the figures reported in the literature, suggesting the earliest possible diagnosis and timely intervention are critically important to attain successful outcomes.

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The increase in the number of cardiac operations has brought about an increase in aortic pathology that requires reoperation. The aim of the present study was to evaluate axillary artery cannulation in aortic reoperations. We operated on 23 patients diagnosed with acute type A aortic dissection (13 patients), chronic type A aortic dissection (7 patients), aortic pseudoaneursym (2 patients), and arcus aorta aneurysm (1 patient). The right axillary artery was cannulated directly or through a side graft which was anastomosed to the artery. Antegrade cerebral perfusion with moderate degree hypothermia was used for cerebral protection. Four patients were lost after the operation (17.4%) and no cerebral complications were encountered. Axillary artery cannulation provides safe reentry to the chest and provides good cerebral protection in aortic reoperations.

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Gender disparities in ECG variables and susceptibility to arrhythmia exist. The basis of these sex-related distinctions in cardiac electrophysiology has been extensively studied in various species, but is virtually unexplored in humans. The aim of this study was to clarify the cellular basis of electrophysiological gender disparities in human cardiac myocytes.
Human midmyocardial left ventricular myocytes were isolated from explanted hearts of male and female patients in end-stage heart failure at the time of cardiac transplantation. The action potentials, sarcolemmal ion currents, and susceptibility to the generation of early afterdepolarizations were studied using whole-cell patch-clamp methodology. The functional effects of gender disparities in sarcolemmal ion currents were assessed by computer simulations using the Priebe-Beuckelmann or the ten Tusscher-Noble-Noble-Panfilov human ventricular cell models.
Female myocytes had significantly longer action potentials and greater susceptibility to early afterdepolarizations than male myocytes. All other action potential parameters (resting membrane potential, amplitude, plateau level, upstroke velocity, maximal velocity of phase-1 and phase-3 repolarization) had similar values for both genders. In female myocytes, the transient outward potassium current (I_to1) tended to be smaller, while the L-type calcium current (I_Ca,L) and quasi-steady state current (I_QSS) tended to be larger. Computer simulations showed that these subtle differences in sarcolemmal ion currents may conspire to cause the observed gender disparities in action potential properties.
Female failing myocytes have longer action potentials and a greater susceptibility to early afterdepolarizations than male failing myocytes. These gender disparities may be due to slightly larger depolarizing I_Ca,L in conjunction with slightly smaller repolarizing I_QSS and I_to1 in female myocytes.

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A 45-year-old female who had cardiac surgery 40 years earlier was transferred to our hospital because of refractory fever. Echocardiography showed an intrapericardial mass. Gallium-67 (⁶⁷Ga) scintigraphy revealed abnormal accumulation at the same site of the intrapericardial mass and thoracoscopy revealed that the mass was a pericardial abscess (PA). After surgical resection, drainage and antibiotic therapy, her fever subsided and the abnormal accumulation of ⁶⁷Ga disappeared. This case showed a very rare clinical course of PA and the importance of ⁶⁷Ga scintigraphy for its diagnosis.

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We present clinical follow-up of a 20-year-old male with an aortic aneurysm secondary to aortic coarctation. The diagnosis of aortic aneurysm secondary to aortic coarctation was made in 1997. The patient did not agree to undergo any invasive or therapeutic procedures at that time. He presented to an emergency unit with severe chest pain after chest trauma obtained during judo exercises in 1998.
Two-dimensional echocardiography showed bicuspid aortic valves, an ascending aortic aneurysm 6 cm in diameter with an intimal flap and false lumen, aortic coarctation distal to the left subclavian artery, and aortic insufficiency secondary to annular dilatation. Type II aortic dissection was confirmed by transesophageal echocardiography, which showed the dissection was confined to the ascending aorta. The dissection extended to the beginning of the arcus aorta.
Following stabilization of the patient's clinical condition, balloon coarctation angioplasty was performed to reduce afterload and hypertension and to facilitate femoral artery cannulation for cardiopulmonary bypass. Surgical procedures included resection of the aortic valve and prosthetic valve implantation, resection of the ascending aorta, and interposition of a 22 mm Hamashied tubular vascular graft.
At a follow-up visit 6 years later, the patient reported being easily fatigued and having palpitations. He had been suffering from hemolytic anemia and mild renal function impairment. Cardiac catheterisation and angiography showed a 40 mmHg gradient due to kinking of the aortic graft and no gradient at the coarctation site. We postulated the kinking of the aortic vascular graft may be related to an inappropriate vascular graft length. We also thought that the severe hemolysis was attributable to the disturbance of blood flow by a jet of blood at the site of the kinking aortic vascular graft. A second operation was performed because the renal function of the patient had decreased progressively and hemolysis symptoms increased. After the second operation, hemolysis on peripheral blood smears had disappeared and renal function had shown progressive improvements.

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Optical coherence tomography (OCT) has recently been proposed as a high-resolution imaging method. Our male patient, who had been treated with a coronary stent, died due to acute leukemia. Coronary artery images using intravascular ultrasound (IVUS) and OCT were obtained postmortem. We also compared the image of neointima formation after stent implantation evaluated by histopathological examination with that evaluated by IVUS and OCT. OCT visualized well-apposed stent struts and neointima formation, which could not be visualized completely by IVUS. OCT may be useful for monitoring structural changes after stent implantation.

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