Jinwei Tian1, Xuefeng Ren2, Shiro Uemura3, Harold Dauerman4, Abhiram Prasad5, Catalin Toma6, Haibo Jia1, Farhad Abtahian7, Rocco Vergallo7, Sining Hu1, Iris McNulty7, Hang Lee8, Stephen Lee9, Bo Yu10, Ik-Kyung Jang11. 1. Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University; the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 2. Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University; the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China. 3. Nara Medical University, Nara, Japan. 4. University of Vermont, Fletcher Allen Healthcare, Burlington, VT. 5. Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN. 6. University of Pittsburgh Medical Center, Pittsburgh, PA. 7. Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 8. Biostatistics, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 9. Department of Medicine, Queen Mary Hospital, Hong Kong University, Hong Kong, China. 10. Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University; the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China. Electronic address: yubodr@163.com. 11. Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: ijang@partners.org.
Abstract
BACKGROUND: Development of neoatherosclerosis (NA) has been reported to be a potential cause of late stent failure. However, the distribution of NA and its relationship with neovascularization (NV) and adjacent plaque characteristics remain unclear. METHODS: We investigated 167 stents (40 bare-metal stents, 84 sirolimus-eluting stents, and 43 everolimus-eluting stents) with optical coherence tomography. Each stent was divided into the proximal section (PS), mid section (MS) and distal section (DS). Neoatherosclerosis was defined as lipid-laden neointima or calcification inside stent. Adjacent plaque characteristics were evaluated within 5 mm proximal and distal reference segments. RESULTS: Neoatherosclerosis was more frequent in PS and DS than in MS (PS 19.8% vs. MS 3.6% vs. DS 21%: PS vs. MS, P < .001: MS vs. DS, P < .001). Neovascularization in PS and DS was also more prevalent compared with that in MS (PS 15% vs. MS 5.4% vs. DS 13.8%: PS vs. MS, P = .001: MS vs. DS, P = .001). Neoatherosclerosis was more frequently observed in stents with intraintima NV (68.6% vs. 20.5%, P < .001). The incidence of NA was higher, when adjacent plaque was lipid (43.2% with lipid plaque vs. 12.2% without lipid plaque, P < .001). CONCLUSION: Neoatherosclerosis occurs more frequently at PS and DS. Neoatherosclerosis was associated with NV and adjacent lipid plaque, suggesting potential interrelationship between development of NA and NV and adjacent plaque characteristics.
BACKGROUND: Development of neoatherosclerosis (NA) has been reported to be a potential cause of late stent failure. However, the distribution of NA and its relationship with neovascularization (NV) and adjacent plaque characteristics remain unclear. METHODS: We investigated 167 stents (40 bare-metal stents, 84 sirolimus-eluting stents, and 43 everolimus-eluting stents) with optical coherence tomography. Each stent was divided into the proximal section (PS), mid section (MS) and distal section (DS). Neoatherosclerosis was defined as lipid-laden neointima or calcification inside stent. Adjacent plaque characteristics were evaluated within 5 mm proximal and distal reference segments. RESULTS: Neoatherosclerosis was more frequent in PS and DS than in MS (PS 19.8% vs. MS 3.6% vs. DS 21%: PS vs. MS, P < .001: MS vs. DS, P < .001). Neovascularization in PS and DS was also more prevalent compared with that in MS (PS 15% vs. MS 5.4% vs. DS 13.8%: PS vs. MS, P = .001: MS vs. DS, P = .001). Neoatherosclerosis was more frequently observed in stents with intraintima NV (68.6% vs. 20.5%, P < .001). The incidence of NA was higher, when adjacent plaque was lipid (43.2% with lipid plaque vs. 12.2% without lipid plaque, P < .001). CONCLUSION: Neoatherosclerosis occurs more frequently at PS and DS. Neoatherosclerosis was associated with NV and adjacent lipid plaque, suggesting potential interrelationship between development of NA and NV and adjacent plaque characteristics.