Neoatherosclerosis assessed with optical coherence tomography in restenotic bare metal and first- and second-generation drug-eluting stents View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-08

AUTHORS

Lei Song, Gary S. Mintz, Dong Yin, Myong Hwa Yamamoto, Chee Yang Chin, Mitsuaki Matsumura, Khady Fall, Ajay J. Kirtane, Manish A. Parikh, Jeffrey W. Moses, Ziad A. Ali, Richard A. Shlofmitz, Akiko Maehara

ABSTRACT

Although reported in bare metal stents (BMS) and first-generation drug-eluting stents (DES), little is known about neoatherosclerosis in second-generation DES. We used optical coherence tomography to evaluate neoatherosclerosis among different stent generations. Overall, 274 in-stent restenosis (ISR) lesions (duration from implantation 56.9 ± 47.2 months) in 274 patients were assessed for the presence of neoatherosclerosis. Neoatherosclerosis was identified in 38.7% of lesions (106/274): 23.0% second-generation DES (38/165), 65.1% first-generation DES (54/83), and 53.8% BMS (14/26). In the neoatherosclerosis cohort (n = 106), more stent underexpansion or fracture/deformation was observed in second-generation DES, whereas thrombus, without plaque rupture, or evagination was more common in first-generation DES. In multivariable analyses, duration from implantation >1 year (OR: 2.44, 95% CI 1.12-5.31; p = 0.03), absence of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (OR 1.95, 95% CI 1.10-3.44; p = 0.02) or statins at the time of ISR (OR 3.12, 95% CI 1.42-6.84; p = 0.01), and first-generation vs first-generation DES (OR 5.32, 95% CI 2.82-10.10; p < 0.001) correlated with a higher prevalence of neoatherosclerosis. Duration from implantation <1 year (OR 2.17, 95% CI 1.03-4.55; p = 0.04) and thin fibrous cap, thrombus, or rupture (OR 2.72, 95% CI 1.15-6.39; p = 0.02) were independent predictors for acute coronary syndromes presentation. Neoatherosclerosis is an important ISR mechanism, especially in first generation DES. More... »

PAGES

1115-1124

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10554-017-1106-2

DOI

http://dx.doi.org/10.1007/s10554-017-1106-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1084025456

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28281026


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