Spatial heterogeneity of neoatherosclerosis and its relationship with neovascularization and adjacent plaque characteristics: Optical coherence tomography study

Jinwei Tian, Xuefeng Ren, Shiro Uemura, Harold Dauerman, Abhiram Prasad, Catalin Toma, Haibo Jia, Farhad Abtahian, Rocco Vergallo, Sining Hu, Iris McNulty, Hang Lee, Stephen Lee, Bo Yu, Ik Kyung Jang

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19 Scopus citations

Abstract

Background Development of neoatherosclerosis (NA) has been reported to be a potential cause of late stent failure. However, the distribution of NA and its relationship with neovascularization (NV) and adjacent plaque characteristics remain unclear. Methods We investigated 167 stents (40 bare-metal stents, 84 sirolimus-eluting stents, and 43 everolimus-eluting stents) with optical coherence tomography. Each stent was divided into the proximal section (PS), mid section (MS) and distal section (DS). Neoatherosclerosis was defined as lipid-laden neointima or calcification inside stent. Adjacent plaque characteristics were evaluated within 5 mm proximal and distal reference segments. Results Neoatherosclerosis was more frequent in PS and DS than in MS (PS 19.8% vs MS 3.6% vs DS 21%: PS vs MS, P <.001: MS vs DS, P <.001). Neovascularization in PS and DS was also more prevalent compared with that in MS (PS 15% vs MS 5.4% vs DS 13.8%: PS vs MS, P =.001: MS vs DS, P =.001). Neoatherosclerosis was more frequently observed in stents with intraintima NV (68.6% vs 20.5%, P <.001). The incidence of NA was higher, when adjacent plaque was lipid (43.2% with lipid plaque vs 12.2% without lipid plaque, P <.001). Conclusion Neoatherosclerosis occurs more frequently at PS and DS. Neoatherosclerosis was associated with NV and adjacent lipid plaque, suggesting potential interrelationship between development of NA and NV and adjacent plaque characteristics.

Original languageEnglish (US)
Pages (from-to)884-892.e2
JournalAmerican heart journal
Volume167
Issue number6
DOIs
StatePublished - Jun 2014

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Tian, J., Ren, X., Uemura, S., Dauerman, H., Prasad, A., Toma, C., Jia, H., Abtahian, F., Vergallo, R., Hu, S., McNulty, I., Lee, H., Lee, S., Yu, B., & Jang, I. K. (2014). Spatial heterogeneity of neoatherosclerosis and its relationship with neovascularization and adjacent plaque characteristics: Optical coherence tomography study. American heart journal, 167(6), 884-892.e2. https://doi.org/10.1016/j.ahj.2014.03.013