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Predictors for Neoatherosclerosis: A Retrospective Observational Study from the Optical Coherence Tomography Registry.
MedLine Citation:
PMID:  22798521     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -Recent studies have reported development of neoatherosclerosis (NA) inside the stents several years after stent implantation. The aim of this study was to determine the predictors for NA using optical coherence tomography (OCT). METHODS AND RESULTS: -From a total of 1080 patients who underwent OCT, we identified 179 stents in 151 patients in which the mean neointimal thickness was >100 μm. The presence of lipid-laden neointima or calcification inside the stents was defined as NA in the present study. Patient characteristics, stent type, and time since stent implantation (stent age) were compared between stents with or without NA. Univariable and multivariable logistic regression analyses were employed to assess the independent predictors. In univariate analysis, stent age ≥48 months [OR 2.65 (95%CI 1.43-4.92), p=0.002], drug-eluting stents [DES, OR 3.03 (95%CI 1.53-6.01), p=0.002], age ≥65 years old [OR 1.91 (95%CI 1.05-3.44), p=0.032], current smoking [OR 2.30 (95%CI 1.10-4.82), p=0.024], chronic kidney disease [CKD, OR 4.17 (95%CI 1.42-12.23), p=0.009], and angiotensin converting enzyme inhibitors (ACE-I) or angiotensin II receptor blockade (ARB) use [OR 0.42 (95%CI 0.22-0.80), p=0.008] were significant predictors. In multivariate analysis, stent age ≥48 months, all sub-types of DES, current smoking, CKD, and ACE-I/ARB use remained independent predictors for NA. CONCLUSIONS: -In addition to the stent type and the stent age, patient characteristics, including current smoking, CKD, and ACE-I/ARB, were associated with the presence of NA. This result may support the importance of secondary prevention after stent implantation.
Authors:
Taishi Yonetsu; Koji Kato; Soo-Joong Kim; Lei Xing; Haibo Jia; Iris McNulty; Hang Lee; Shaosong Zhang; Shiro Uemura; Yangsoo Jang; Soo-Jin Kang; Seung-Jung Park; Stephen Lee; Bo Yu; Tsunekazu Kakuta; Ik-Kyung Jang
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-13
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1 Massachusetts General Hospital and Harvard Medical School, Boston, MA;
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