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

Authors
 Choongki Kim  ;  Byeong-Keuk Kim  ;  Seung-Yul Lee  ;  Dong-Ho Shin  ;  Jung-Sun Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Myeong-Ki Hong 
Citation
 AMERICAN HEART JOURNAL, Vol.170(3) : 591-597, 2015 
Journal Title
 AMERICAN HEART JOURNAL 
ISSN
 0002-8703 
Issue Date
2015
MeSH
Arteriosclerosis/diagnosis ; Arteriosclerosis/epidemiology* ; Arteriosclerosis/etiology ; Coronary Artery Disease/surgery* ; Coronary Vessels/pathology* ; Drug-Eluting Stents/adverse effects* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Middle Aged ; Neointima/pathology* ; Odds Ratio ; Percutaneous Coronary Intervention/adverse effects* ; Republic of Korea/epidemiology ; Retrospective Studies ; Time Factors ; Tomography, Optical Coherence/methods
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0002870315003750
DOI
10.1016/j.ahj.2015.06.005
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Kim, Choong Ki(김충기)
Shin, Dong Ho(신동호) ORCID logo https://orcid.org/0000-0002-7874-5542
Lee, Seung Yul(이승율)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141127
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