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Impact of attenuated-signal plaque observed by intravascular ultrasound on vessel response after drug-eluting stent implantation.

Abstract：

BACKGROUND AND AIMS:The aim of this study was to investigate the impact of attenuated-signal plaque (ASP) observed by intravascular ultrasound (IVUS) on vessel response after drug-eluting stent implantation. METHODS:Data were derived from the IVUS cohort of the J-DESsERT trial comparing paclitaxel- and sirolimus-eluting stents. Serial IVUS analysis (pre- and post-intervention, and 8-month follow-up) was performed in 136 non-AMI lesions. ASP was defined as hypoechoic plaque with ultrasound attenuation without calcification. Calcified plaque (CP) was defined as brightly echoreflective plaque with acoustic shadowing. ASP and CP scores were calculated by grading their measured angle as 0 to 4 for 0°, <90°, 90-180°, 180-270° and >270°, respectively. The entire stented segment was analyzed at 1-mm intervals. RESULTS:At pre-intervention, ASP was observed in 40.4% of lesions, and this group had greater % neointimal volume (%NIV) at follow-up than the no-ASP group (p = 0.011). ASP score at pre-intervention positively correlated with %NIV (p = 0.023). During the follow-up, ASP score significantly decreased (p < 0.001), and CP score significantly increased (p < 0.001), with a negative correlation between them (p < 0.001). A decrease in the ASP score was associated with less %NIV in PES (p = 0.031), but not in SES (p = 0.229). CONCLUSIONS:The greater extent of plaque with IVUS-signal attenuation at pre-intervention and its persistence during follow-up were associated with neointimal proliferation, possibly representing sustained inflammatory status, depending on the type of DES used.

journal_name

Atherosclerosis

journal_title

Atherosclerosis

authors

Kitahara H,Waseda K,Sakamoto K,Yamada R,Huang CC,Nakatani D,Sakata K,Kawarada O,Yock PG,Matsuyama Y,Yokoi H,Nakamura M,Muramatsu T,Nanto S,Fitzgerald PJ,Honda Y

doi

10.1016/j.atherosclerosis.2017.02.009

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

68-74

eissn

0021-9150

issn

1879-1484

pii

S0021-9150(17)30061-8

journal_volume

259

pub_type

杂志文章,多中心研究,随机对照试验

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