Impact of baseline plaque characteristic on the development of neoatherosclerosis in the very late phase after stenting.
Aged
Atherosclerosis
/ etiology
Female
Humans
Logistic Models
Male
Middle Aged
Neointima
/ etiology
Odds Ratio
Percutaneous Coronary Intervention
/ adverse effects
Plaque, Atherosclerotic
/ complications
Postoperative Complications
/ etiology
Preoperative Period
Retrospective Studies
Stents
/ adverse effects
Time Factors
Tomography, Optical Coherence
/ methods
Coronary artery disease
Neoatherosclerosis
Optical coherence tomography
Percutaneous coronary intervention
Journal
Journal of cardiology
ISSN: 1876-4738
Titre abrégé: J Cardiol
Pays: Netherlands
ID NLM: 8804703
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
23
08
2018
revised:
16
11
2018
accepted:
18
01
2019
pubmed:
9
2
2019
medline:
24
6
2020
entrez:
9
2
2019
Statut:
ppublish
Résumé
Neoatherosclerosis (NA) is recognized as an important contributing factor to very late stent failure. The aim of this study was to investigate whether preprocedural underlying plaque morphology is associated with the development of NA using optical coherence tomography (OCT). One-hundred thirteen stents [25 bare metal stents, 22 first-generation drug-eluting stents (DES), 66 second-generation DES] from 98 patients who underwent percutaneous coronary intervention with pre-percutaneous coronary intervention (PCI) OCT and very late OCT examination >3 years after stenting were retrospectively studied. In OCT analysis, NA was defined as a neointima with lipid or calcification. In-stent lipid volume index was defined as the in-stent averaged lipid arc multiplied by in-stent lipid length. In all, 28 stents were implanted to the culprit lesions of acute coronary syndrome (ACS) and 85 stents were in stable lesions. NA was observed in 29 stents (25.7%) and the median duration from PCI to remote OCT examination was 5.1 (4.0-6.1) years. Multivariable logistic regression analysis revealed that low-density lipoprotein cholesterol (LDL-C) at follow-up OCT [odds ratio (OR) 1.03, 95% confidence interval (CI) 1.01-1.04, p<0.001], stent age (OR 2.13, 95% CI 1.36-3.31, p=0.001), and thin-cap fibroatheroma (TCFA) at baseline culprit lesions (OR 14.2, 95% CI 4.6-43.8, p<0.001) were independent predictors for the development of NA. In multiple linear regression analysis, in-stent lipid volume index was significantly correlated with LDL-C at follow-up OCT, stent age, the target lesion of ACS, and OCT-TCFA at baseline. In addition to the known predictors, underlying plaque characteristics at the time of stenting was significantly associated with the development of NA at approximately 5 years after stent implantation.
Sections du résumé
BACKGROUND
BACKGROUND
Neoatherosclerosis (NA) is recognized as an important contributing factor to very late stent failure. The aim of this study was to investigate whether preprocedural underlying plaque morphology is associated with the development of NA using optical coherence tomography (OCT).
METHODS
METHODS
One-hundred thirteen stents [25 bare metal stents, 22 first-generation drug-eluting stents (DES), 66 second-generation DES] from 98 patients who underwent percutaneous coronary intervention with pre-percutaneous coronary intervention (PCI) OCT and very late OCT examination >3 years after stenting were retrospectively studied. In OCT analysis, NA was defined as a neointima with lipid or calcification. In-stent lipid volume index was defined as the in-stent averaged lipid arc multiplied by in-stent lipid length.
RESULTS
RESULTS
In all, 28 stents were implanted to the culprit lesions of acute coronary syndrome (ACS) and 85 stents were in stable lesions. NA was observed in 29 stents (25.7%) and the median duration from PCI to remote OCT examination was 5.1 (4.0-6.1) years. Multivariable logistic regression analysis revealed that low-density lipoprotein cholesterol (LDL-C) at follow-up OCT [odds ratio (OR) 1.03, 95% confidence interval (CI) 1.01-1.04, p<0.001], stent age (OR 2.13, 95% CI 1.36-3.31, p=0.001), and thin-cap fibroatheroma (TCFA) at baseline culprit lesions (OR 14.2, 95% CI 4.6-43.8, p<0.001) were independent predictors for the development of NA. In multiple linear regression analysis, in-stent lipid volume index was significantly correlated with LDL-C at follow-up OCT, stent age, the target lesion of ACS, and OCT-TCFA at baseline.
CONCLUSION
CONCLUSIONS
In addition to the known predictors, underlying plaque characteristics at the time of stenting was significantly associated with the development of NA at approximately 5 years after stent implantation.
Identifiants
pubmed: 30733110
pii: S0914-5087(19)30004-8
doi: 10.1016/j.jjcc.2019.01.002
pii:
doi:
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
67-73Informations de copyright
Copyright © 2019 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.