Choongki Kim1, Byeong-Keuk Kim2, Seung-Yul Lee1, Dong-Ho Shin2, Jung-Sun Kim2, Young-Guk Ko2, Donghoon Choi2, Yangsoo Jang3, Myeong-Ki Hong4. 1. Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea. 2. Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea. 3. Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea. 4. Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea. Electronic address: mkhong61@yuhs.ac.
Abstract
BACKGROUND: Compared with bare-metal stents, neoatherosclerosis reportedly develops earlier and more frequently after drug-eluting stent (DES) implantation. This study evaluated the incidence, clinical presentation, and predictors of early neoatherosclerosis after DES implantation. METHODS: Neointimal characteristics were evaluated in 449 patients (482 lesions) who underwent follow-up optical coherence tomography ≤12 months after DES implantation (median 9.1 months) and displayed a mean neointimal thickness >100 μm. Neoatherosclerosis was defined as neointima with the presence of lipid or calcification. RESULTS: Early neoatherosclerosis, defined as occurrence of neoatherosclerosis within 12 months after DES implantation, was observed in 31 lesions (6.4%). Compared with patients without early neoatherosclerosis, those with early neoatherosclerosis presented with a higher incidence of clinical symptoms (13% vs 57%, respectively; P < .001) and had undergone a higher frequency of target-lesion revascularization (9% vs 55%, respectively; P < .001) at the time of optical coherence tomography follow-up. Multivariate logistic regression analysis showed that independent predictors of early neoatherosclerosis were hypertension (odds ratio 3.20, 95% CI 1.32-7.78, P = .010) and pre-stent low-density lipoprotein cholesterol ≥130 mg/dL at the time of the index procedure (odds ratio 3.89, 95% CI, 1.62-9.36, P = .002). CONCLUSIONS: Early neoatherosclerosis was detected in 6.4% of DES-treated lesions with neointimal thickness >100 μm at a median of 9.1 months after DES implantation. The occurrence of early neoatherosclerosis was significantly associated with presentation of clinical symptoms. Independent predictors of early neoatherosclerosis were hypertension and high pre-stent low-density lipoprotein cholesterol at the time of the index procedure.
BACKGROUND: Compared with bare-metal stents, neoatherosclerosis reportedly develops earlier and more frequently after drug-eluting stent (DES) implantation. This study evaluated the incidence, clinical presentation, and predictors of early neoatherosclerosis after DES implantation. METHODS: Neointimal characteristics were evaluated in 449 patients (482 lesions) who underwent follow-up optical coherence tomography ≤12 months after DES implantation (median 9.1 months) and displayed a mean neointimal thickness >100 μm. Neoatherosclerosis was defined as neointima with the presence of lipid or calcification. RESULTS: Early neoatherosclerosis, defined as occurrence of neoatherosclerosis within 12 months after DES implantation, was observed in 31 lesions (6.4%). Compared with patients without early neoatherosclerosis, those with early neoatherosclerosis presented with a higher incidence of clinical symptoms (13% vs 57%, respectively; P < .001) and had undergone a higher frequency of target-lesion revascularization (9% vs 55%, respectively; P < .001) at the time of optical coherence tomography follow-up. Multivariate logistic regression analysis showed that independent predictors of early neoatherosclerosis were hypertension (odds ratio 3.20, 95% CI 1.32-7.78, P = .010) and pre-stent low-density lipoprotein cholesterol ≥130 mg/dL at the time of the index procedure (odds ratio 3.89, 95% CI, 1.62-9.36, P = .002). CONCLUSIONS: Early neoatherosclerosis was detected in 6.4% of DES-treated lesions with neointimal thickness >100 μm at a median of 9.1 months after DES implantation. The occurrence of early neoatherosclerosis was significantly associated with presentation of clinical symptoms. Independent predictors of early neoatherosclerosis were hypertension and high pre-stent low-density lipoprotein cholesterol at the time of the index procedure.
Authors: Keyvan Karim Galougahi; Ori Ben-Yehuda; Akiko Maehara; Gary S Mintz; Gregg W Stone; Ziad A Ali Journal: J Thorac Dis Date: 2016-10 Impact factor: 2.895
Authors: Chongying Jin; Ryo Torii; Anantharaman Ramasamy; Vincenzo Tufaro; Callum D Little; Klio Konstantinou; Yi Ying Tan; Nathan A L Yap; Jackie Cooper; Tom Crake; Constantinos O'Mahony; Roby Rakhit; Mohaned Egred; Javed Ahmed; Grigoris Karamasis; Lorenz Räber; Andreas Baumbach; Anthony Mathur; Christos V Bourantas Journal: Front Cardiovasc Med Date: 2022-05-26