Lei Gao1, Seung-Jung Park2, Yangsoo Jang3, Stephen Lee4, Chong-Jin Kim5, Yoshiyasu Minami1, Daniel Ong1, Tsunenari Soeda6, Rocco Vergallo1, Hang Lee7, Bo Yu8, Shiro Uemura9, Ik-Kyung Jang10. 1. Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. 2. Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. 3. Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea. 4. Queen Mary Hospital, Hong Kong University, Hong Kong. 5. Division of Cardiology, Kyung-Hee University, Seoul, South Korea. 6. Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; The First Department of Medicine, Nara Medical University, Nara, Japan. 7. Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. 8. Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China. 9. The First Department of Medicine, Nara Medical University, Nara, Japan. 10. Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Division of Cardiology, Kyung-Hee University, Seoul, South Korea. Electronic address: IJANG@mgh.harvard.edu.
Abstract
OBJECTIVES: This study aimed to investigate the characteristics of neoatherosclerosis (NA) in patients with diabetes mellitus (DM) after drug-eluting stent (DES) implantation using optical coherence tomography. BACKGROUND: NA is an important substrate for stent failure. In vivo NA characteristics in DM patients have not been investigated. METHODS: A total of 397 patients with 452 DES who underwent follow-up optical coherence tomography examination after DES implantation were enrolled. Characteristics of NA were compared between DM and non-DM patients. Neovascularization was defined as signal-poor holes or tubular structures with a diameter of 50 to 300 μm. RESULTS: A total of 123 DES with NA lesions in 115 patients were identified. The incidence of NA was similar between DM and non-DM patients (29.6% vs. 28.6%; p = 0.825). Compared with the non-DM group, neovascularization was more frequently observed in the DM group (55.1% vs. 32.4%; p = 0.012). The multivariate logistic model demonstrated that DM (odds ratio: 3.00; 95% confidence interval: 1.31 to 6.81; p = 0.009) and follow-up duration (odds ratio: 1.03; 95% confidence interval: 1.02 to 1.05; p < 0.001) were the independent predictors for neovascularization in NA lesions. DM patients with glycated hemoglobin ≥7.0% had a higher prevalence of thin-cap fibroatheroma compared with those with glycated hemoglobin <7.0% (40.0% vs. 8.3%; p = 0.01). CONCLUSIONS: The incidence of NA was similar between patients with and without DM. Neovascularization in NA lesions was more frequent in those with DM. Poorly controlled DM patients had a higher incidence of thin-cap fibroatheroma, compared with those with well-controlled DM.
OBJECTIVES: This study aimed to investigate the characteristics of neoatherosclerosis (NA) in patients with diabetes mellitus (DM) after drug-eluting stent (DES) implantation using optical coherence tomography. BACKGROUND: NA is an important substrate for stent failure. In vivo NA characteristics in DMpatients have not been investigated. METHODS: A total of 397 patients with 452 DES who underwent follow-up optical coherence tomography examination after DES implantation were enrolled. Characteristics of NA were compared between DM and non-DMpatients. Neovascularization was defined as signal-poor holes or tubular structures with a diameter of 50 to 300 μm. RESULTS: A total of 123 DES with NA lesions in 115 patients were identified. The incidence of NA was similar between DM and non-DMpatients (29.6% vs. 28.6%; p = 0.825). Compared with the non-DM group, neovascularization was more frequently observed in the DM group (55.1% vs. 32.4%; p = 0.012). The multivariate logistic model demonstrated that DM (odds ratio: 3.00; 95% confidence interval: 1.31 to 6.81; p = 0.009) and follow-up duration (odds ratio: 1.03; 95% confidence interval: 1.02 to 1.05; p < 0.001) were the independent predictors for neovascularization in NA lesions. DMpatients with glycated hemoglobin ≥7.0% had a higher prevalence of thin-cap fibroatheroma compared with those with glycated hemoglobin <7.0% (40.0% vs. 8.3%; p = 0.01). CONCLUSIONS: The incidence of NA was similar between patients with and without DM. Neovascularization in NA lesions was more frequent in those with DM. Poorly controlled DMpatients had a higher incidence of thin-cap fibroatheroma, compared with those with well-controlled DM.
Authors: Grzegorz K Jakubiak; Natalia Pawlas; Grzegorz Cieślar; Agata Stanek Journal: Int J Environ Res Public Health Date: 2021-11-15 Impact factor: 3.390