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Incidence, clinical presentation, and predictors of early neoatherosclerosis after drug-eluting stent implantation

 Choongki Kim  ;  Byeong-Keuk Kim  ;  Seung-Yul Lee  ;  Dong-Ho Shin  ;  Jung-Sun Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Myeong-Ki Hong 
 American Heart Journal, Vol.170(3) : 591-597, 2015 
Journal Title
 American Heart Journal 
Issue Date
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.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
고영국(Ko, Young Guk) ; 김병극(Kim, Byeong Keuk) ; 김중선(Kim, Jung Sun) ; 김충기(Kim, Choong Ki) ; 신동호(Shin, Dong Ho) ; 이승율(Lee, Seung Yul) ; 장양수(Jang, Yang Soo) ; 최동훈(Choi, Dong Hoon) ; 홍명기(Hong, Myeong Ki)
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