Comparison of Neoatherosclerosis and Neovascularization between Patients with and Without Diabetes An Optical Coherence Tomography Study

Lei Gao, Seung Jung Park, Yangsoo Jang, Stephen Lee, Chong Jin Kim, Yoshiyasu Minami, Daniel Ong, Tsunenari Soeda, Rocco Vergallo, Hang Lee, Bo Yu, Shiro Uemura, Ik Kyung Jang

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Abstract

Objectives This study aimed to investigate the characteristics of neoatherosclerosis (NA) in patients with diabetes mellitus (DM) after drug-eluting stent (DES) implantation using optical coherence tomography. Background NA is an important substrate for stent failure. In vivo NA characteristics in DM patients have not been investigated. Methods A total of 397 patients with 452 DES who underwent follow-up optical coherence tomography examination after DES implantation were enrolled. Characteristics of NA were compared between DM and non-DM patients. Neovascularization was defined as signal-poor holes or tubular structures with a diameter of 50 to 300 μm. Results A total of 123 DES with NA lesions in 115 patients were identified. The incidence of NA was similar between DM and non-DM patients (29.6% vs. 28.6%; p = 0.825). Compared with the non-DM group, neovascularization was more frequently observed in the DM group (55.1% vs. 32.4%; p = 0.012). The multivariate logistic model demonstrated that DM (odds ratio: 3.00; 95% confidence interval: 1.31 to 6.81; p = 0.009) and follow-up duration (odds ratio: 1.03; 95% confidence interval: 1.02 to 1.05; p < 0.001) were the independent predictors for neovascularization in NA lesions. DM patients with glycated hemoglobin ≥7.0% had a higher prevalence of thin-cap fibroatheroma compared with those with glycated hemoglobin <7.0% (40.0% vs. 8.3%; p = 0.01). Conclusions The incidence of NA was similar between patients with and without DM. Neovascularization in NA lesions was more frequent in those with DM. Poorly controlled DM patients had a higher incidence of thin-cap fibroatheroma, compared with those with well-controlled DM.

Original languageEnglish
Pages (from-to)1044-1052
Number of pages9
JournalJACC: Cardiovascular Interventions
Volume8
Issue number8
DOIs
Publication statusPublished - 2015 Jul 1

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Optical Coherence Tomography
Diabetes Mellitus
Drug-Eluting Stents
Glycosylated Hemoglobin A
Atherosclerotic Plaques
Incidence
Odds Ratio
Confidence Intervals
Stents
Logistic Models

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Gao, Lei ; Park, Seung Jung ; Jang, Yangsoo ; Lee, Stephen ; Kim, Chong Jin ; Minami, Yoshiyasu ; Ong, Daniel ; Soeda, Tsunenari ; Vergallo, Rocco ; Lee, Hang ; Yu, Bo ; Uemura, Shiro ; Jang, Ik Kyung. / Comparison of Neoatherosclerosis and Neovascularization between Patients with and Without Diabetes An Optical Coherence Tomography Study. In: JACC: Cardiovascular Interventions. 2015 ; Vol. 8, No. 8. pp. 1044-1052.
@article{4b589da09e3e473996e951760c99c1d1,
title = "Comparison of Neoatherosclerosis and Neovascularization between Patients with and Without Diabetes An Optical Coherence Tomography Study",
abstract = "Objectives This study aimed to investigate the characteristics of neoatherosclerosis (NA) in patients with diabetes mellitus (DM) after drug-eluting stent (DES) implantation using optical coherence tomography. Background NA is an important substrate for stent failure. In vivo NA characteristics in DM patients have not been investigated. Methods A total of 397 patients with 452 DES who underwent follow-up optical coherence tomography examination after DES implantation were enrolled. Characteristics of NA were compared between DM and non-DM patients. Neovascularization was defined as signal-poor holes or tubular structures with a diameter of 50 to 300 μm. Results A total of 123 DES with NA lesions in 115 patients were identified. The incidence of NA was similar between DM and non-DM patients (29.6{\%} vs. 28.6{\%}; p = 0.825). Compared with the non-DM group, neovascularization was more frequently observed in the DM group (55.1{\%} vs. 32.4{\%}; p = 0.012). The multivariate logistic model demonstrated that DM (odds ratio: 3.00; 95{\%} confidence interval: 1.31 to 6.81; p = 0.009) and follow-up duration (odds ratio: 1.03; 95{\%} confidence interval: 1.02 to 1.05; p < 0.001) were the independent predictors for neovascularization in NA lesions. DM patients with glycated hemoglobin ≥7.0{\%} had a higher prevalence of thin-cap fibroatheroma compared with those with glycated hemoglobin <7.0{\%} (40.0{\%} vs. 8.3{\%}; p = 0.01). Conclusions The incidence of NA was similar between patients with and without DM. Neovascularization in NA lesions was more frequent in those with DM. Poorly controlled DM patients had a higher incidence of thin-cap fibroatheroma, compared with those with well-controlled DM.",
author = "Lei Gao and Park, {Seung Jung} and Yangsoo Jang and Stephen Lee and Kim, {Chong Jin} and Yoshiyasu Minami and Daniel Ong and Tsunenari Soeda and Rocco Vergallo and Hang Lee and Bo Yu and Shiro Uemura and Jang, {Ik Kyung}",
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Gao, L, Park, SJ, Jang, Y, Lee, S, Kim, CJ, Minami, Y, Ong, D, Soeda, T, Vergallo, R, Lee, H, Yu, B, Uemura, S & Jang, IK 2015, 'Comparison of Neoatherosclerosis and Neovascularization between Patients with and Without Diabetes An Optical Coherence Tomography Study', JACC: Cardiovascular Interventions, vol. 8, no. 8, pp. 1044-1052. https://doi.org/10.1016/j.jcin.2015.02.020

Comparison of Neoatherosclerosis and Neovascularization between Patients with and Without Diabetes An Optical Coherence Tomography Study. / Gao, Lei; Park, Seung Jung; Jang, Yangsoo; Lee, Stephen; Kim, Chong Jin; Minami, Yoshiyasu; Ong, Daniel; Soeda, Tsunenari; Vergallo, Rocco; Lee, Hang; Yu, Bo; Uemura, Shiro; Jang, Ik Kyung.

In: JACC: Cardiovascular Interventions, Vol. 8, No. 8, 01.07.2015, p. 1044-1052.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of Neoatherosclerosis and Neovascularization between Patients with and Without Diabetes An Optical Coherence Tomography Study

AU - Gao, Lei

AU - Park, Seung Jung

AU - Jang, Yangsoo

AU - Lee, Stephen

AU - Kim, Chong Jin

AU - Minami, Yoshiyasu

AU - Ong, Daniel

AU - Soeda, Tsunenari

AU - Vergallo, Rocco

AU - Lee, Hang

AU - Yu, Bo

AU - Uemura, Shiro

AU - Jang, Ik Kyung

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Objectives This study aimed to investigate the characteristics of neoatherosclerosis (NA) in patients with diabetes mellitus (DM) after drug-eluting stent (DES) implantation using optical coherence tomography. Background NA is an important substrate for stent failure. In vivo NA characteristics in DM patients have not been investigated. Methods A total of 397 patients with 452 DES who underwent follow-up optical coherence tomography examination after DES implantation were enrolled. Characteristics of NA were compared between DM and non-DM patients. Neovascularization was defined as signal-poor holes or tubular structures with a diameter of 50 to 300 μm. Results A total of 123 DES with NA lesions in 115 patients were identified. The incidence of NA was similar between DM and non-DM patients (29.6% vs. 28.6%; p = 0.825). Compared with the non-DM group, neovascularization was more frequently observed in the DM group (55.1% vs. 32.4%; p = 0.012). The multivariate logistic model demonstrated that DM (odds ratio: 3.00; 95% confidence interval: 1.31 to 6.81; p = 0.009) and follow-up duration (odds ratio: 1.03; 95% confidence interval: 1.02 to 1.05; p < 0.001) were the independent predictors for neovascularization in NA lesions. DM patients with glycated hemoglobin ≥7.0% had a higher prevalence of thin-cap fibroatheroma compared with those with glycated hemoglobin <7.0% (40.0% vs. 8.3%; p = 0.01). Conclusions The incidence of NA was similar between patients with and without DM. Neovascularization in NA lesions was more frequent in those with DM. Poorly controlled DM patients had a higher incidence of thin-cap fibroatheroma, compared with those with well-controlled DM.

AB - Objectives This study aimed to investigate the characteristics of neoatherosclerosis (NA) in patients with diabetes mellitus (DM) after drug-eluting stent (DES) implantation using optical coherence tomography. Background NA is an important substrate for stent failure. In vivo NA characteristics in DM patients have not been investigated. Methods A total of 397 patients with 452 DES who underwent follow-up optical coherence tomography examination after DES implantation were enrolled. Characteristics of NA were compared between DM and non-DM patients. Neovascularization was defined as signal-poor holes or tubular structures with a diameter of 50 to 300 μm. Results A total of 123 DES with NA lesions in 115 patients were identified. The incidence of NA was similar between DM and non-DM patients (29.6% vs. 28.6%; p = 0.825). Compared with the non-DM group, neovascularization was more frequently observed in the DM group (55.1% vs. 32.4%; p = 0.012). The multivariate logistic model demonstrated that DM (odds ratio: 3.00; 95% confidence interval: 1.31 to 6.81; p = 0.009) and follow-up duration (odds ratio: 1.03; 95% confidence interval: 1.02 to 1.05; p < 0.001) were the independent predictors for neovascularization in NA lesions. DM patients with glycated hemoglobin ≥7.0% had a higher prevalence of thin-cap fibroatheroma compared with those with glycated hemoglobin <7.0% (40.0% vs. 8.3%; p = 0.01). Conclusions The incidence of NA was similar between patients with and without DM. Neovascularization in NA lesions was more frequent in those with DM. Poorly controlled DM patients had a higher incidence of thin-cap fibroatheroma, compared with those with well-controlled DM.

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