Author + information
- Seung–Yul Lee,
- Byeong–Keuk Kim,
- Jung–Sun Kim,
- Dong–Ho Shin,
- Young–Guk Ko,
- Donghoon Choi,
- Yangsoo Jang and
- Myeong–Ki Hong
Atherosclerotic changes within in–stent neointimal tissue, which might be considered as a mechanism of late stent failure, have not been sufficiently investigated.
Neointimal characteristics of 152 lesions (128 drug–eluting stents [DESs] and 24 bare–metal stents [BMSs]) with >50% of percent cross–sectional area stenosis of neointima were evaluated. Median time interval to follow–up OCT was 33.9 months. Neoatherosclerosis was defined as neointima with presence of lipid or calcification.
Neoatherosclerosis was observed in 54 lesions (35.5%, 35 DESs and 19 BMSs). Median time interval to follow–up OCT was 70.7 months in the lesions with neoatherosclerosis. The optimal cut–off time to predict neoatherosclerosis in DES–treated lesions was 30 months with a sensitivity of 91.4% and a specificity of 72.0% (area under curve= 0.839, 95% confidence interval [CI]=0.764–0.898, p<0.001). Independent risk factors for neoatherosclerosis were stent age (odds ratio=1.058, 95% CI=1.035–1.082, p<0.001), use of DES (odds ratio=18.116, 95% CI=1.423–230.711, p=0.026) and hypertension (odds ratio=4.174, 95% CI=1.341–12.999, p=0.014). Patients with neoatherosclerosis (versus those without neoatherosclerosis) had a higher rate of target lesion revascularization (92.6% vs. 77.6%, respectively, p=0.018) and stent thrombosis (14.8% vs. 0%, respectively, p<0.001).
This OCT study suggested that neoatherosclerosis occurred in one–thirds of stented lesions during extended follow–up periods. Independent risk factors for neoatherosclerosis were stent age, use of DES and hypertension. Neoatherosclerosis might be involved in deterioration of clinical prognosis at late phase after stent implantation.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Intravascular Imaging: IVUS and OCT
Abstract Category: 38. TCT@ACC–i2: Intravascular Imaging and Physiology
Presentation Number: 2108–255
- 2013 American College of Cardiology Foundation