The impact of acute coronary syndrome on late drug-eluting stents restenosis: Insights from optical coherence tomography. Issue 52 (December 2017)

• Record Type: Journal Article
• Authors: Wu, Sijing; Liu, Wei; Guo, Yonghe; Zeng, Yaping; Zhou, Zhiming; Zhao, Yingxin; Liu, Yuyang; Shi, Dongmei; Wang, Zhijian; Ge, Hailong; Wang, Jianlong; Jin, Peng; Zhou, Yujie
• Other Names: Zhang. Heye section editor.
• Is Part Of: Medicine. Volume 96:Issue 52(2017)
• Publication Date: 2017-12
• Subjects: acute coronary syndrome -- drug-eluting stent -- in-stent restenosis -- optical coherence tomography; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000009515
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: The aim of the study was to investigate the optical coherence tomography (OCT)-identified difference of in-stent restenosis (ISR) tissue characteristics between patients with and without acute coronary syndrome (ACS) at index intervention. The retrospective study included 80 patients with 85 drug-eluting stent (DES) restenosis lesions. Subjects were classified according to clinical presentation at the time of de-novo lesion intervention, namely ACS and non-ACS. OCT was performed at 5 years follow-up. The frequency of malapposition, neointimal characteristics, thrombus, and minimal stent area (MSA) were evaluated. ACS group consisted of 48 (60%) patients. The mean duration from initial intervention to OCT study was 66.15 months. Malapposition was more frequent in the ACS group (25.5% vs 2.9%, P = .006), as well as a higher prevalence of thrombus in the ACS group (21.6% vs 0%, P = .015). MSA of ACS group was significantly less than that of non-ACS group (4.99 ± 1.80 vs 5.62 ± 2.08 mm 2, P = .018). Compared with non-ACS group, only MI group was related to smaller MSA (4.37 ± 1.39 vs 5.62 ± 2.08 mm 2, P = .048); The unstable angina (UA) group was not associated with a decreased MSA. The occurrence of neoatherosclerosis tended to be higher in ACS group (60.8% vs 41.2%, P = .076). In DES restenosis, an ACS presentation at initial intervention is associated with a higher incidence of malapposition, thrombus, and smaller MSA.