Ji-Yong Jang1, Jung-Sun Kim2, Dong-Ho Shin2, Byeong-Keuk Kim2, Young-Guk Ko2, Donghoon Choi2, Yangsoo Jang3, Myeong-Ki Hong4. 1. Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, South Korea. 2. Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, South Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea. 3. Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, South Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea. 4. Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, South Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: mkhong61@yuhs.ac.
Abstract
OBJECTIVE: Serial follow-up optical coherence tomography (OCT) was used to evaluate the effect of optimal lipid-lowering therapy on qualitative changes in neointimal tissue characteristics after drug-eluting stent (DES) implantation. METHODS: DES-treated patients (n = 218) who received statin therapy were examined with serial follow-up OCT. First and second follow-up OCT evaluations were performed approximately 6 and 18 months after the index procedure, respectively. Patients were divided into two groups, based on the level of low-density lipoprotein-cholesterol (LDL-C), which was measured at the second follow-up. The optimal lipid-lowering group (n = 121) had an LDL-C reduction of ≥50% or an LDL-C level ≤70 mg/dL, and the conventional group (n = 97). Neointimal characteristics were qualitatively categorized as homogeneous or non-homogeneous patterns using OCT. The non-homogeneous group included heterogeneous, layered, or neoatherosclerosis patterns. Qualitative changes in neointimal tissue characteristics between the first and second follow-up OCT examinations were assessed. RESULTS: Between the first and second follow-up OCT procedures, the neointimal cross-sectional area increased more substantially in the conventional group (0.4 mm(2) vs. 0.2 mm(2) in the optimal lipid-lowering group, p = 0.01). The neointimal pattern changed from homogeneous to non-homogeneous less often in the optimal lipid-lowering group (1.3%, 1/77, p < 0.001) than in the conventional group (15.3%, 11/72, p = 0.44). Optimal LDL-C reduction was an independent predictor for the prevention of neointimal pattern change from homogeneous to non-homogeneous (odds ratio: 0.05, 95% confidence interval: 0.01∼0.46, p = 0.008). CONCLUSION: Our findings suggest that an intensive reduction in LDL-C levels can prevent non-homogeneous changes in the neointima and increases in neointimal cross-sectional area compared with conventional LDL-C controls.
OBJECTIVE: Serial follow-up optical coherence tomography (OCT) was used to evaluate the effect of optimal lipid-lowering therapy on qualitative changes in neointimal tissue characteristics after drug-eluting stent (DES) implantation. METHODS: DES-treated patients (n = 218) who received statin therapy were examined with serial follow-up OCT. First and second follow-up OCT evaluations were performed approximately 6 and 18 months after the index procedure, respectively. Patients were divided into two groups, based on the level of low-density lipoprotein-cholesterol (LDL-C), which was measured at the second follow-up. The optimal lipid-lowering group (n = 121) had an LDL-C reduction of ≥50% or an LDL-C level ≤70 mg/dL, and the conventional group (n = 97). Neointimal characteristics were qualitatively categorized as homogeneous or non-homogeneous patterns using OCT. The non-homogeneous group included heterogeneous, layered, or neoatherosclerosis patterns. Qualitative changes in neointimal tissue characteristics between the first and second follow-up OCT examinations were assessed. RESULTS: Between the first and second follow-up OCT procedures, the neointimal cross-sectional area increased more substantially in the conventional group (0.4 mm(2) vs. 0.2 mm(2) in the optimal lipid-lowering group, p = 0.01). The neointimal pattern changed from homogeneous to non-homogeneous less often in the optimal lipid-lowering group (1.3%, 1/77, p < 0.001) than in the conventional group (15.3%, 11/72, p = 0.44). Optimal LDL-C reduction was an independent predictor for the prevention of neointimal pattern change from homogeneous to non-homogeneous (odds ratio: 0.05, 95% confidence interval: 0.01∼0.46, p = 0.008). CONCLUSION: Our findings suggest that an intensive reduction in LDL-C levels can prevent non-homogeneous changes in the neointima and increases in neointimal cross-sectional area compared with conventional LDL-C controls.
Authors: Ioannis Andreou; Saeko Takahashi; Masaya Tsuda; Koki Shishido; Antonios P Antoniadis; Michail I Papafaklis; Shingo Mizuno; Ahmet U Coskun; Shigeru Saito; Charles L Feldman; Elazer R Edelman; Peter H Stone Journal: Atherosclerosis Date: 2016-07-22 Impact factor: 5.162
Authors: Bugra Ozkan; Özcan Örsçelik; Hakan Uyar; Mehmet Ballı; Eren Güçer; Onur Aslan; Gülhan Temel; Ahmet Çelik; İsmail Türkay Özcan Journal: Biomed Res Int Date: 2018-06-07 Impact factor: 3.411
Authors: Tomasz Roleder; Keyvan Karimi Galougahi; Chee Yang Chin; Navdeep K Bhatti; Emmanouil Brilakis; Tamim M Nazif; Ajay J Kirtane; Dimitri Karmpaliotis; Wojciech Wojakowski; Martin B Leon; Gary S Mintz; Akiko Maehara; Gregg W Stone; Ziad A Ali Journal: Eur Heart J Cardiovasc Imaging Date: 2017-06-01 Impact factor: 6.875