Abstract 11626: Predictors for Neoatherosclerosis: A Retrospective Observational Study from the Optical Coherence Tomography Registry
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 subjects who underwent OCT, we identified 179 stents in 151 subjects in whom 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. Cut-off stent age to differentiate NA was determined with receiver operating curve (ROC) analysis in drug-eluting stents (DES) and bare-metal stents (BMS). Univariable and multivariable logistic regression analyses were employed to assess the independent predictors. Out of 179 stents, NA was observed in 84 stents (46.9%). Cut-off stent ages to differentiate NA were 14 months for DES and 55 months for BMS. In univariate analysis, stent age ≥48 months [OR 2.65 (95%CI 1.43-4.92), p=0.002], DES [OR 2.65 (95%CI 2.41-13.24), p<0.001], 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 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, any sub-types of DES, current smoking, CKD, and ACI-I or ARB use remained independent predictors for NA.
Conclusion: 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.
- © 2012 by American Heart Association, Inc.