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We sought to evaluate the impact of renal dysfunction on stent strut coverage and neointimal tissue characteristics averaged 12 months after drug-eluting stent implantation assessed by optical coherence tomography (OCT).
Seventy-one patients with 104 drug-eluting stents were divided into 3 groups according to estimated glomerular filtration rate(eGFR): group A (eGFR <60 ml/min/1.73 m2, np=20, Ns=30), group B (eGFR≥60 and < 90 ml/min/1.73 m2, np=26, Ns=39), and group C (eGFR≥90 ml/min/1.73 m2, np=25,Ns=35). Quantitative and qualitative neointimal tissue characteristics were evaluated using OCT.
The patients in group A were significantly older than those in the other two groups(65.8±6.9 years [group A], 56.7±10.1 years [group B], and 50.9±11.1 years [group C], p<0.001). The percentage of uncovered struts(9.0±6.1% [group A], 4.6±4.4% [group B], and 3.1±2.0% [group C], P=0.001) and malapposed struts(1.1±0.9% [group A], 0.4±0.7% [group B], and 0.3±0.6% [group C], P=0.006) were more frequently observed in group A than in groups B and C. Lipid-laden neointima was more frequently detected in group A, followed by group B and group C (20.0% [group A], 7.7% [group B], and 2.9% [group C], p=0.021).
Renal dysfunction was significantly associated with delayed intimal coverage and a higher incidence of lipid-laden neointima. The complicated stent healing state may explain an increased risk of late stent failure in patients with CKD.