Relationship between quantities of tissue prolapse after percutaneous coronary intervention and neointimal hyperplasia at follow-up on serial optical coherence tomography examination. (15th August 2017)

• Record Type: Journal Article
• Authors: Sugiyama, Tomoyo; Kimura, Shigeki; Ohtani, Hirofumi; Hishikari, Keiichi; Kojima, Keisuke; Sagawa, Yuichiro; Hayasaka, Kazuto; Mizusawa, Masafumi; Misawa, Toru; Yamakami, Yosuke; Hikita, Hiroyuki; Takahashi, Atsushi; Isobe, Mitsuaki
• Is Part Of: International journal of cardiology. Volume 241(2017)
• Page Start: 470
• Page End: 477
• Publication Date: 2017-08-15
• Subjects: Coronary artery disease -- Tissue prolapse -- Neointimal hyperplasia -- Optical coherence tomography; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2017.01.155
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: The clinical significance of the extent of tissue prolapse (TP) after percutaneous coronary intervention (PCI) for long-term outcomes remains undetermined. This study investigated the relationship between the quantities of TP immediately after PCI and neointimal hyperplasia (NIH) at follow-up on serial optical coherence tomography (OCT) examination. Methods: We evaluated 145 native coronary lesions (89 lesions with stable angina pectoris [SAP] and 56 with acute coronary syndrome [ACS]). OCT was performed to examine pre-PCI plaque morphologies at the narrowest culprit sites, post-PCI TP area in each cross-sectional area (CSA) and TP volume throughout the stented segments, 9-month follow-up NIH area in each CSA and NIH volume throughout the stented segments. We investigated the relationships between the quantities of TP and NIH and their differences according to clinical presentation. Results: ACS lesions had a larger TP area at the narrowest culprit sites (0.39 [0.14–0.85] vs. 0.11 [0.00–0.32] mm 2, P < 0.001) and at the most protruding sites (0.51 [0.24–1.08] vs. 0.21 [0.10–0.52] mm 2, P < 0.001) compared with SAP lesions. In ACS lesions, TP area was correlated with NIH area at the culprit sites ( r = 0.283, P = 0.042) and at the most protruding sites ( r = 0.288, P = 0.038). In SAP lesions, TP area was correlated with NIH area at the most protruding sites ( r = 0.244, P = 0.030), but not at the culprit sites. Conclusions: The extent of TP immediately after PCI was quantitatively related to the degree of NIH at 9-month follow-up on serial OCT examination. The quantities of TP might influence long-term stent outcomes. Highlights: Significance of tissue prolapse (TP) for long-term outcomes remains undetermined. We evaluated the quantities of TP and neointimal hyperplasia (NIH) by serial OCT. The extent of TP after PCI was related to the degree of NIH at 9-month follow-up. Quantification of TP may be useful for predicting NIH and long-term stent outcomes.