Correlation between degree of neointimal hyperplasia and incidence and characteristics of neoatherosclerosis as assessed by optical coherence tomography

Rocco Vergallo, Taishi Yonetsu, Shiro Uemura, Seung Jung Park, Stephen Lee, Koji Kato, Haibo Jia, Farhad Abtahian, Jinwei Tian, Sining Hu, Hang Lee, Iris McNulty, Abhiram Prasad, Bo Yu, Shaosong Zhang, Italo Porto, Luigi M. Biasucci, Filippo Crea, Ik Kyung Jang

Research output: Contribution to journalArticle

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Abstract

Emerging evidence suggests that neointimal degenerative changes with development of neoatherosclerosis (NA) may represent an important mechanism for late stent failure. The aim of the present study was to investigate the relation between degree of neointimal hyperplasia and incidence and characteristics of NA using optical coherence tomography. We identified a total of 252 stents with mean neointimal thickness (NIT) >100 μm in 212 patients: 100 bare metal stents (BMSs) and 152 drug-eluting stents (DESs). Based on the values of mean NIT, we divided stents into tertiles and compared neointimal characteristics among the 3 groups. NA was defined as the presence of lipid-laden intima and/or calcification inside the stent. In both BMS and DES, there was a difference in the prevalence of lipid-laden intima among the tertiles (18.2% vs 36.4% vs 47.1%, p = 0.042 [BMS]; 19.6% vs 56.9% vs 88.0%, p <0.001 [DES]). However, no difference in the prevalence of in-stent calcification was observed (21.2% vs 21.2% vs 2.9%, p = 0.053 [BMS]; 5.9% vs 9.8% vs 2.0%, p = 0.252 [DES]). In a multivariate model adjusting for stent type, follow-up duration, conventional coronary risk factors, statin, and angiotensin-converting enzyme inhibitor or angiotensin II receptor blockade use, mean NIT was independently associated with the presence of NA (odds ratio 2.53, 95% confidence interval 1.96 to 3.27, p <0.001). This study demonstrates the presence of a positive correlation between degree of neointimal hyperplasia after stent implantation and presence of lipid-laden intima. This association is independent from stent type and time from implantation and suggests a possible pathogenic link between the two processes.

Original languageEnglish (US)
Pages (from-to)1315-1321
Number of pages7
JournalAmerican Journal of Cardiology
Volume112
Issue number9
DOIs
StatePublished - Nov 1 2013

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Optical Coherence Tomography
Hyperplasia
Stents
Incidence
Drug-Eluting Stents
Metals
Lipids
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Angiotensin Receptors
Angiotensin-Converting Enzyme Inhibitors
Odds Ratio
Confidence Intervals

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Correlation between degree of neointimal hyperplasia and incidence and characteristics of neoatherosclerosis as assessed by optical coherence tomography. / Vergallo, Rocco; Yonetsu, Taishi; Uemura, Shiro; Park, Seung Jung; Lee, Stephen; Kato, Koji; Jia, Haibo; Abtahian, Farhad; Tian, Jinwei; Hu, Sining; Lee, Hang; McNulty, Iris; Prasad, Abhiram; Yu, Bo; Zhang, Shaosong; Porto, Italo; Biasucci, Luigi M.; Crea, Filippo; Jang, Ik Kyung.

In: American Journal of Cardiology, Vol. 112, No. 9, 01.11.2013, p. 1315-1321.

Research output: Contribution to journalArticle

Vergallo, R, Yonetsu, T, Uemura, S, Park, SJ, Lee, S, Kato, K, Jia, H, Abtahian, F, Tian, J, Hu, S, Lee, H, McNulty, I, Prasad, A, Yu, B, Zhang, S, Porto, I, Biasucci, LM, Crea, F & Jang, IK 2013, 'Correlation between degree of neointimal hyperplasia and incidence and characteristics of neoatherosclerosis as assessed by optical coherence tomography', American Journal of Cardiology, vol. 112, no. 9, pp. 1315-1321. https://doi.org/10.1016/j.amjcard.2013.05.076
Vergallo, Rocco ; Yonetsu, Taishi ; Uemura, Shiro ; Park, Seung Jung ; Lee, Stephen ; Kato, Koji ; Jia, Haibo ; Abtahian, Farhad ; Tian, Jinwei ; Hu, Sining ; Lee, Hang ; McNulty, Iris ; Prasad, Abhiram ; Yu, Bo ; Zhang, Shaosong ; Porto, Italo ; Biasucci, Luigi M. ; Crea, Filippo ; Jang, Ik Kyung. / Correlation between degree of neointimal hyperplasia and incidence and characteristics of neoatherosclerosis as assessed by optical coherence tomography. In: American Journal of Cardiology. 2013 ; Vol. 112, No. 9. pp. 1315-1321.
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abstract = "Emerging evidence suggests that neointimal degenerative changes with development of neoatherosclerosis (NA) may represent an important mechanism for late stent failure. The aim of the present study was to investigate the relation between degree of neointimal hyperplasia and incidence and characteristics of NA using optical coherence tomography. We identified a total of 252 stents with mean neointimal thickness (NIT) >100 μm in 212 patients: 100 bare metal stents (BMSs) and 152 drug-eluting stents (DESs). Based on the values of mean NIT, we divided stents into tertiles and compared neointimal characteristics among the 3 groups. NA was defined as the presence of lipid-laden intima and/or calcification inside the stent. In both BMS and DES, there was a difference in the prevalence of lipid-laden intima among the tertiles (18.2{\%} vs 36.4{\%} vs 47.1{\%}, p = 0.042 [BMS]; 19.6{\%} vs 56.9{\%} vs 88.0{\%}, p <0.001 [DES]). However, no difference in the prevalence of in-stent calcification was observed (21.2{\%} vs 21.2{\%} vs 2.9{\%}, p = 0.053 [BMS]; 5.9{\%} vs 9.8{\%} vs 2.0{\%}, p = 0.252 [DES]). In a multivariate model adjusting for stent type, follow-up duration, conventional coronary risk factors, statin, and angiotensin-converting enzyme inhibitor or angiotensin II receptor blockade use, mean NIT was independently associated with the presence of NA (odds ratio 2.53, 95{\%} confidence interval 1.96 to 3.27, p <0.001). This study demonstrates the presence of a positive correlation between degree of neointimal hyperplasia after stent implantation and presence of lipid-laden intima. This association is independent from stent type and time from implantation and suggests a possible pathogenic link between the two processes.",
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AU - Vergallo, Rocco

AU - Yonetsu, Taishi

AU - Uemura, Shiro

AU - Park, Seung Jung

AU - Lee, Stephen

AU - Kato, Koji

AU - Jia, Haibo

AU - Abtahian, Farhad

AU - Tian, Jinwei

AU - Hu, Sining

AU - Lee, Hang

AU - McNulty, Iris

AU - Prasad, Abhiram

AU - Yu, Bo

AU - Zhang, Shaosong

AU - Porto, Italo

AU - Biasucci, Luigi M.

AU - Crea, Filippo

AU - Jang, Ik Kyung

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N2 - Emerging evidence suggests that neointimal degenerative changes with development of neoatherosclerosis (NA) may represent an important mechanism for late stent failure. The aim of the present study was to investigate the relation between degree of neointimal hyperplasia and incidence and characteristics of NA using optical coherence tomography. We identified a total of 252 stents with mean neointimal thickness (NIT) >100 μm in 212 patients: 100 bare metal stents (BMSs) and 152 drug-eluting stents (DESs). Based on the values of mean NIT, we divided stents into tertiles and compared neointimal characteristics among the 3 groups. NA was defined as the presence of lipid-laden intima and/or calcification inside the stent. In both BMS and DES, there was a difference in the prevalence of lipid-laden intima among the tertiles (18.2% vs 36.4% vs 47.1%, p = 0.042 [BMS]; 19.6% vs 56.9% vs 88.0%, p <0.001 [DES]). However, no difference in the prevalence of in-stent calcification was observed (21.2% vs 21.2% vs 2.9%, p = 0.053 [BMS]; 5.9% vs 9.8% vs 2.0%, p = 0.252 [DES]). In a multivariate model adjusting for stent type, follow-up duration, conventional coronary risk factors, statin, and angiotensin-converting enzyme inhibitor or angiotensin II receptor blockade use, mean NIT was independently associated with the presence of NA (odds ratio 2.53, 95% confidence interval 1.96 to 3.27, p <0.001). This study demonstrates the presence of a positive correlation between degree of neointimal hyperplasia after stent implantation and presence of lipid-laden intima. This association is independent from stent type and time from implantation and suggests a possible pathogenic link between the two processes.

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