Abstract 17443: Neoatherosclerosis within Sirolimus-Eluting Stent may Reflect the Extent of Atherosclerotic Progression in Patient with Coronary Artery Disease
Background: Pathological studies have revealed atherosclerotic changes within neointima (neoatherosclerosis) after sirolimus-eluting stents (SES) implantation. Whether neoatherosclerosis occurs along with atherosclerotic progression in other segment or it is confined to stented segment remains unclear.
Methods: We evaluated 47 patients (64 SES) by serial coronary angiography (CAG) and optical coherence tomography (OCT) 6 months and 5 years after stenting. We assessed atherogenic neointima (AN: neointima containing a diffuse border, signal-poor region with invisible struts underneath) by OCT at 5 years and divided the lesions into +AN and -AN group. In addition to the stented segments, distal adjacent segments (<1mm from the SES distal edge) and non-culprit, intermediate lesions (>5mm distal to SES) within the same vessel were also serially evaluated.
Results: The prevalence of AN was 23.4% (15/64 stents) at 5 years. In the stented segment, minimum lumen diameter (MLD) by CAG and mean lumen area (MLA) by OCT significantly decreased from 6 months to 5 years in the both groups and delayed late luminal diameter loss (MLD at 6 months - MLD at 5 years) and late lumen area loss (MLA at 6 months - MLA at 5 years) didn’t differ between the groups. In the distal adjacent segments, delayed late lumen area loss was significantly greater in +AN than in -AN group. In the non-culprit lesions, MLD significantly decreased from 6 months to 5 years in +AN group, while unchanged in -AN group. Delayed late luminal diameter loss was significantly greater in the non-culprit lesions of +AN than those of -AN group (Table).
Conclusions: Neoatherosclerosis appear to occur along with atherosclerotic progression in other segment. AN is not a specific phenomenon observed only within SES, rather it may reflect the extent of systemic atherosclerosis in coronary artery disease patients.
- © 2012 by American Heart Association, Inc.