Atherosclerotic plaque behind the stent changes after bare-metal and drug-eluting stent implantation in humans: Implications for late stent failure?
Background and aims The natural history and the role of atherosclerotic plaque located behind the stent (PBS) are still poorly understood. We evaluated the serial changes in PBS following bare-metal (BMS) compared to first-generation drug-eluting stent (DES) implantation and the impact of these chan...
| Main Authors: | , , , , , , , , , , , |
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| Other Authors: | |
| Format: | Article |
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Elsevier
2017
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| Online Access: | http://hdl.handle.net/1721.1/112774 https://orcid.org/0000-0001-9373-705X https://orcid.org/0000-0002-5646-0378 https://orcid.org/0000-0002-7832-7156 |
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| author | Takahashi, Saeko Tsuda, Masaya Shishido, Koki Mizuno, Shingo Coskun, Ahmet U. Saito, Shigeru Feldman, Charles L. Stone, Peter H. Andreou, Ioannis Antoniadis, Antonios Papafaklis, Michail Edelman, Elazer R |
| author2 | Massachusetts Institute of Technology. Institute for Medical Engineering & Science |
| author_facet | Massachusetts Institute of Technology. Institute for Medical Engineering & Science Takahashi, Saeko Tsuda, Masaya Shishido, Koki Mizuno, Shingo Coskun, Ahmet U. Saito, Shigeru Feldman, Charles L. Stone, Peter H. Andreou, Ioannis Antoniadis, Antonios Papafaklis, Michail Edelman, Elazer R |
| author_sort | Takahashi, Saeko |
| collection | MIT |
| description | Background and aims The natural history and the role of atherosclerotic plaque located behind the stent (PBS) are still poorly understood. We evaluated the serial changes in PBS following bare-metal (BMS) compared to first-generation drug-eluting stent (DES) implantation and the impact of these changes on in-stent neointimal hyperplasia (NIH). Methods Three-dimensional coronary reconstruction by angiography and intravascular ultrasound was performed after intervention and at 6–10-month follow-up in 157 patients with 188 lesions treated with BMS (n = 89) and DES (n = 99). Results There was a significant decrease in PBS area (−7.2%; p < 0.001) and vessel area (−1.7%; p < 0.001) after BMS and a respective increase in both areas after DES implantation (6.1%; p < 0.001 and 4.1%; p < 0.001, respectively). The decrease in PBS area significantly predicted neointimal area at follow-up after BMS (β: 0.15; 95% confidence interval [CI]: 0.10–0.20, p < 0.001) and DES (β: 0.09; 95% CI: 0.07–0.11; p < 0.001) implantation. The decrease in PBS area was the most powerful predictor of significant NIH after BMS implantation (odds ratio: 1.13; 95% CI: 1.02–1.26; p = 0.02). Conclusions The decrease in PBS area after stent implantation is significantly associated with the magnitude of NIH development at follow-up. This finding raises the possibility of a communication between the lesion within the stent and the underlying native atherosclerotic plaque, and may have important implications regarding the pathobiology of in-stent restenosis and late/very late stent thrombosis. |
| first_indexed | 2024-09-23T11:03:58Z |
| format | Article |
| id | mit-1721.1/112774 |
| institution | Massachusetts Institute of Technology |
| last_indexed | 2024-09-23T11:03:58Z |
| publishDate | 2017 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | mit-1721.1/1127742022-10-01T00:55:58Z Atherosclerotic plaque behind the stent changes after bare-metal and drug-eluting stent implantation in humans: Implications for late stent failure? Takahashi, Saeko Tsuda, Masaya Shishido, Koki Mizuno, Shingo Coskun, Ahmet U. Saito, Shigeru Feldman, Charles L. Stone, Peter H. Andreou, Ioannis Antoniadis, Antonios Papafaklis, Michail Edelman, Elazer R Massachusetts Institute of Technology. Institute for Medical Engineering & Science Andreou, Ioannis Antoniadis, Antonios Papafaklis, Michail Edelman, Elazer R Background and aims The natural history and the role of atherosclerotic plaque located behind the stent (PBS) are still poorly understood. We evaluated the serial changes in PBS following bare-metal (BMS) compared to first-generation drug-eluting stent (DES) implantation and the impact of these changes on in-stent neointimal hyperplasia (NIH). Methods Three-dimensional coronary reconstruction by angiography and intravascular ultrasound was performed after intervention and at 6–10-month follow-up in 157 patients with 188 lesions treated with BMS (n = 89) and DES (n = 99). Results There was a significant decrease in PBS area (−7.2%; p < 0.001) and vessel area (−1.7%; p < 0.001) after BMS and a respective increase in both areas after DES implantation (6.1%; p < 0.001 and 4.1%; p < 0.001, respectively). The decrease in PBS area significantly predicted neointimal area at follow-up after BMS (β: 0.15; 95% confidence interval [CI]: 0.10–0.20, p < 0.001) and DES (β: 0.09; 95% CI: 0.07–0.11; p < 0.001) implantation. The decrease in PBS area was the most powerful predictor of significant NIH after BMS implantation (odds ratio: 1.13; 95% CI: 1.02–1.26; p = 0.02). Conclusions The decrease in PBS area after stent implantation is significantly associated with the magnitude of NIH development at follow-up. This finding raises the possibility of a communication between the lesion within the stent and the underlying native atherosclerotic plaque, and may have important implications regarding the pathobiology of in-stent restenosis and late/very late stent thrombosis. 2017-12-18T14:28:49Z 2017-12-18T14:28:49Z 2016-07 2016-05 2017-12-14T19:13:57Z Article http://purl.org/eprint/type/JournalArticle 0021-9150 http://hdl.handle.net/1721.1/112774 Andreou, Ioannis et al. “Atherosclerotic Plaque Behind the Stent Changes after Bare-Metal and Drug-Eluting Stent Implantation in Humans: Implications for Late Stent Failure?” Atherosclerosis 252 (September 2016): 9–14 © 2016 Elsevier Ireland Ltd https://orcid.org/0000-0001-9373-705X https://orcid.org/0000-0002-5646-0378 https://orcid.org/0000-0002-7832-7156 http://dx.doi.org/10.1016/J.ATHEROSCLEROSIS.2016.07.914 Atherosclerosis Creative Commons Attribution-NonCommercial-NoDerivs License http://creativecommons.org/licenses/by-nc-nd/4.0/ application/pdf Elsevier PMC |
| spellingShingle | Takahashi, Saeko Tsuda, Masaya Shishido, Koki Mizuno, Shingo Coskun, Ahmet U. Saito, Shigeru Feldman, Charles L. Stone, Peter H. Andreou, Ioannis Antoniadis, Antonios Papafaklis, Michail Edelman, Elazer R Atherosclerotic plaque behind the stent changes after bare-metal and drug-eluting stent implantation in humans: Implications for late stent failure? |
| title | Atherosclerotic plaque behind the stent changes after bare-metal and drug-eluting stent implantation in humans: Implications for late stent failure? |
| title_full | Atherosclerotic plaque behind the stent changes after bare-metal and drug-eluting stent implantation in humans: Implications for late stent failure? |
| title_fullStr | Atherosclerotic plaque behind the stent changes after bare-metal and drug-eluting stent implantation in humans: Implications for late stent failure? |
| title_full_unstemmed | Atherosclerotic plaque behind the stent changes after bare-metal and drug-eluting stent implantation in humans: Implications for late stent failure? |
| title_short | Atherosclerotic plaque behind the stent changes after bare-metal and drug-eluting stent implantation in humans: Implications for late stent failure? |
| title_sort | atherosclerotic plaque behind the stent changes after bare metal and drug eluting stent implantation in humans implications for late stent failure |
| url | http://hdl.handle.net/1721.1/112774 https://orcid.org/0000-0001-9373-705X https://orcid.org/0000-0002-5646-0378 https://orcid.org/0000-0002-7832-7156 |
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