Abstract:
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: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: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: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.
journal_name
J Cardioljournal_title
Journal of cardiologyauthors
Hoshino M,Yonetsu T,Kanaji Y,Usui E,Yamaguchi M,Hada M,Hamaya R,Kanno Y,Murai T,Lee T,Kakuta Tdoi
10.1016/j.jjcc.2019.01.002subject
Has Abstractpub_date
2019-07-01 00:00:00pages
67-73issue
1eissn
0914-5087issn
1876-4738pii
S0914-5087(19)30004-8journal_volume
74pub_type
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journal_title:Journal of cardiology
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journal_title:Journal of cardiology
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doi:
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::The effects of elective percutaneous transluminal coronary angioplasty (PTCA) performed one month after coronary reperfusion therapy in patients with acute myocardial infarction (AMI) were observed using exercise Tl-201 myocardial scintigraphy performed before and after PTCA. Myocardial perfusion in Tl-201 scintigraph...
journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.jjcc.2009.08.006
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journal_title:Journal of cardiology
pub_type: 临床试验,杂志文章
doi:
更新日期:2000-05-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:2004-07-01 00:00:00
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journal_title:Journal of cardiology
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doi:
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journal_title:Journal of cardiology
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journal_title:Journal of cardiology
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doi:
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
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journal_title:Journal of cardiology
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doi:
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