Incidence, clinical presentation, and predictors of early neoatherosclerosis after drug-eluting stent implantation

Choongki Kim, Byeong Keuk Kim, Seung Yul Lee, Dong Ho Shin, Jung Sun Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Myeongki Hong

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background Compared with bare-metal stents, neoatherosclerosis reportedly develops earlier and more frequently after drug-eluting stent (DES) implantation. This study evaluated the incidence, clinical presentation, and predictors of early neoatherosclerosis after DES implantation. Methods Neointimal characteristics were evaluated in 449 patients (482 lesions) who underwent follow-up optical coherence tomography 12 months after DES implantation (median 9.1 months) and displayed a mean neointimal thickness >100 μm. Neoatherosclerosis was defined as neointima with the presence of lipid or calcification. Results Early neoatherosclerosis, defined as occurrence of neoatherosclerosis within 12 months after DES implantation, was observed in 31 lesions (6.4%). Compared with patients without early neoatherosclerosis, those with early neoatherosclerosis presented with a higher incidence of clinical symptoms (13% vs 57%, respectively; P <.001) and had undergone a higher frequency of target-lesion revascularization (9% vs 55%, respectively; P <.001) at the time of optical coherence tomography follow-up. Multivariate logistic regression analysis showed that independent predictors of early neoatherosclerosis were hypertension (odds ratio 3.20, 95% CI 1.32-7.78, P =.010) and pre-stent low-density lipoprotein cholesterol ≥130 mg/dL at the time of the index procedure (odds ratio 3.89, 95% CI, 1.62-9.36, P =.002). Conclusions Early neoatherosclerosis was detected in 6.4% of DES-treated lesions with neointimal thickness >100 μm at a median of 9.1 months after DES implantation. The occurrence of early neoatherosclerosis was significantly associated with presentation of clinical symptoms. Independent predictors of early neoatherosclerosis were hypertension and high pre-stent low-density lipoprotein cholesterol at the time of the index procedure.

Original languageEnglish
Pages (from-to)591-597
Number of pages7
JournalAmerican Heart Journal
Volume170
Issue number3
DOIs
Publication statusPublished - 2015 Sep 1

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Drug-Eluting Stents
Incidence
Stents
Neointima
Optical Coherence Tomography
LDL Cholesterol
Cohort Studies
Metals
Hypertension
Lipids

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Choongki ; Kim, Byeong Keuk ; Lee, Seung Yul ; Shin, Dong Ho ; Kim, Jung Sun ; Ko, Young Guk ; Choi, Donghoon ; Jang, Yangsoo ; Hong, Myeongki. / Incidence, clinical presentation, and predictors of early neoatherosclerosis after drug-eluting stent implantation. In: American Heart Journal. 2015 ; Vol. 170, No. 3. pp. 591-597.
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title = "Incidence, clinical presentation, and predictors of early neoatherosclerosis after drug-eluting stent implantation",
abstract = "Background Compared with bare-metal stents, neoatherosclerosis reportedly develops earlier and more frequently after drug-eluting stent (DES) implantation. This study evaluated the incidence, clinical presentation, and predictors of early neoatherosclerosis after DES implantation. Methods Neointimal characteristics were evaluated in 449 patients (482 lesions) who underwent follow-up optical coherence tomography 12 months after DES implantation (median 9.1 months) and displayed a mean neointimal thickness >100 μm. Neoatherosclerosis was defined as neointima with the presence of lipid or calcification. Results Early neoatherosclerosis, defined as occurrence of neoatherosclerosis within 12 months after DES implantation, was observed in 31 lesions (6.4{\%}). Compared with patients without early neoatherosclerosis, those with early neoatherosclerosis presented with a higher incidence of clinical symptoms (13{\%} vs 57{\%}, respectively; P <.001) and had undergone a higher frequency of target-lesion revascularization (9{\%} vs 55{\%}, respectively; P <.001) at the time of optical coherence tomography follow-up. Multivariate logistic regression analysis showed that independent predictors of early neoatherosclerosis were hypertension (odds ratio 3.20, 95{\%} CI 1.32-7.78, P =.010) and pre-stent low-density lipoprotein cholesterol ≥130 mg/dL at the time of the index procedure (odds ratio 3.89, 95{\%} CI, 1.62-9.36, P =.002). Conclusions Early neoatherosclerosis was detected in 6.4{\%} of DES-treated lesions with neointimal thickness >100 μm at a median of 9.1 months after DES implantation. The occurrence of early neoatherosclerosis was significantly associated with presentation of clinical symptoms. Independent predictors of early neoatherosclerosis were hypertension and high pre-stent low-density lipoprotein cholesterol at the time of the index procedure.",
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Incidence, clinical presentation, and predictors of early neoatherosclerosis after drug-eluting stent implantation. / Kim, Choongki; Kim, Byeong Keuk; Lee, Seung Yul; Shin, Dong Ho; Kim, Jung Sun; Ko, Young Guk; Choi, Donghoon; Jang, Yangsoo; Hong, Myeongki.

In: American Heart Journal, Vol. 170, No. 3, 01.09.2015, p. 591-597.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Incidence, clinical presentation, and predictors of early neoatherosclerosis after drug-eluting stent implantation

AU - Kim, Choongki

AU - Kim, Byeong Keuk

AU - Lee, Seung Yul

AU - Shin, Dong Ho

AU - Kim, Jung Sun

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Jang, Yangsoo

AU - Hong, Myeongki

PY - 2015/9/1

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N2 - Background Compared with bare-metal stents, neoatherosclerosis reportedly develops earlier and more frequently after drug-eluting stent (DES) implantation. This study evaluated the incidence, clinical presentation, and predictors of early neoatherosclerosis after DES implantation. Methods Neointimal characteristics were evaluated in 449 patients (482 lesions) who underwent follow-up optical coherence tomography 12 months after DES implantation (median 9.1 months) and displayed a mean neointimal thickness >100 μm. Neoatherosclerosis was defined as neointima with the presence of lipid or calcification. Results Early neoatherosclerosis, defined as occurrence of neoatherosclerosis within 12 months after DES implantation, was observed in 31 lesions (6.4%). Compared with patients without early neoatherosclerosis, those with early neoatherosclerosis presented with a higher incidence of clinical symptoms (13% vs 57%, respectively; P <.001) and had undergone a higher frequency of target-lesion revascularization (9% vs 55%, respectively; P <.001) at the time of optical coherence tomography follow-up. Multivariate logistic regression analysis showed that independent predictors of early neoatherosclerosis were hypertension (odds ratio 3.20, 95% CI 1.32-7.78, P =.010) and pre-stent low-density lipoprotein cholesterol ≥130 mg/dL at the time of the index procedure (odds ratio 3.89, 95% CI, 1.62-9.36, P =.002). Conclusions Early neoatherosclerosis was detected in 6.4% of DES-treated lesions with neointimal thickness >100 μm at a median of 9.1 months after DES implantation. The occurrence of early neoatherosclerosis was significantly associated with presentation of clinical symptoms. Independent predictors of early neoatherosclerosis were hypertension and high pre-stent low-density lipoprotein cholesterol at the time of the index procedure.

AB - Background Compared with bare-metal stents, neoatherosclerosis reportedly develops earlier and more frequently after drug-eluting stent (DES) implantation. This study evaluated the incidence, clinical presentation, and predictors of early neoatherosclerosis after DES implantation. Methods Neointimal characteristics were evaluated in 449 patients (482 lesions) who underwent follow-up optical coherence tomography 12 months after DES implantation (median 9.1 months) and displayed a mean neointimal thickness >100 μm. Neoatherosclerosis was defined as neointima with the presence of lipid or calcification. Results Early neoatherosclerosis, defined as occurrence of neoatherosclerosis within 12 months after DES implantation, was observed in 31 lesions (6.4%). Compared with patients without early neoatherosclerosis, those with early neoatherosclerosis presented with a higher incidence of clinical symptoms (13% vs 57%, respectively; P <.001) and had undergone a higher frequency of target-lesion revascularization (9% vs 55%, respectively; P <.001) at the time of optical coherence tomography follow-up. Multivariate logistic regression analysis showed that independent predictors of early neoatherosclerosis were hypertension (odds ratio 3.20, 95% CI 1.32-7.78, P =.010) and pre-stent low-density lipoprotein cholesterol ≥130 mg/dL at the time of the index procedure (odds ratio 3.89, 95% CI, 1.62-9.36, P =.002). Conclusions Early neoatherosclerosis was detected in 6.4% of DES-treated lesions with neointimal thickness >100 μm at a median of 9.1 months after DES implantation. The occurrence of early neoatherosclerosis was significantly associated with presentation of clinical symptoms. Independent predictors of early neoatherosclerosis were hypertension and high pre-stent low-density lipoprotein cholesterol at the time of the index procedure.

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