Correlation of angiographic late loss with neointimal coverage of drug-eluting stent struts on follow-up optical coherence tomography

Minimal data have been published on the correlation between angiographic late loss (LL) and incomplete neointimal coverage of struts after drugeluting stent (DES) implantation. Therefore, we evaluated the relationship between angiographic LL and the percentage of uncovered struts on follow-up optical coherence tomography (OCT) images, in all crosssections of the lesions. From the OCT registry database, 219 lesions without restenosis after DES implantation were divided into tertiles based on angiographic LL: tertile I (LL ≤ 0.26 mm), tertile II (0.26< LL<0.59 mm), and tertile III (≥0.59 mm). Lesions with the percentage of uncovered struts in the highest quartile (C75th percentile; ≥6.0%) were defined as highly uncovered; in an independent analysis, lesions without any uncovered strut(s) were defined as completely covered. Higher percentages of uncovered struts were observed in tertile I than in both tertile II and III (10.3 ± 12.8% vs. 4.2 ± 7.4% vs. 2.4 ± 5.1%, respectively; P<0.001 for I vs. II and I vs. III). Angiographic LL correlated significantly with the percentage of uncovered struts on OCT (r = -0.340, P<0.001). The best cut-off values of angiographic LL to predict highly uncovered and completely covered lesions were 0.29 mm (area under curves [AUC] = 0.723, P<0.001) and 0.61 mm (AUC = 0.692, P<0.001), respectively. Angiographic LL inversely and significantly correlated with the percentage of uncovered struts on OCT after DES implantation.