Optical coherence tomographic evaluation of the effect of cigarette smoking on vascular healing after sirolimus-eluting stent implantation

Lei Gao, Seung Jung Park, Yangsoo Jang, Stephen Lee, Jinwei Tian, Yoshiyasu Minami, Haibo Jia, Daniel Ong, Tsunenari Soeda, Rocco Vergallo, Hang Lee, Bo Yu, Shiro Uemura, Ik Kyung Jang

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Abstract

Cigarette smoking is known to be deleterious to patients with coronary artery disease; however, the effect of smoking on vascular responses after coronary drug-eluting stent implantation is unknown. We sought to examine vascular response after sirolimus-eluting stent implantation in patients with ongoing smoking using optical coherence tomography, compared with former smokers and nonsmokers. We identified 181 sirolimus-eluting stents in 140 subjects who underwent follow-up optical coherence tomography imaging. Subjects were divided into 3 groups: current smokers (n = 28), former smokers (n = 35), and nonsmokers (n = 77). Stent strut coverage, neointimal characteristics, and strut malapposition were evaluated. The incidence of uncovered stent struts was significantly higher in nonsmokers compared with current smokers (13.3 ± 13.3% vs 6.7 ± 8.3%; p = 0.001). On qualitative evaluation of neointimal morphology, the prevalence of heterogeneous neointima was higher in current smokers (71.9%) than in former smokers (36.0%) or nonsmokers (10.1%) (p = 0.004 and p <0.001, respectively). There was no difference in the incidence of malapposition among the 3 groups. Multivariate modeling showed that current smoking was negatively associated with the presence of uncovered struts (odds ratio 0.33; 95% confidence interval 0.14 to 0.79; p = 0.013) and positively associated with the presence of heterogeneous neointima (odds ratio 9.47; 95% confidence interval 3.79 to 23.72; p <0.001). In conclusion, the incidence of strut coverage was higher in current smokers compared with nonsmokers. However, the pattern of neointima was more heterogeneous in current smokers.

Original languageEnglish
Pages (from-to)751-757
Number of pages7
JournalAmerican Journal of Cardiology
Volume115
Issue number6
DOIs
Publication statusPublished - 2015 Mar 15

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Gao, L., Park, S. J., Jang, Y., Lee, S., Tian, J., Minami, Y., Jia, H., Ong, D., Soeda, T., Vergallo, R., Lee, H., Yu, B., Uemura, S., & Jang, I. K. (2015). Optical coherence tomographic evaluation of the effect of cigarette smoking on vascular healing after sirolimus-eluting stent implantation. American Journal of Cardiology, 115(6), 751-757. https://doi.org/10.1016/j.amjcard.2014.12.038