Abstract 12510: Relation Between Renal Function and Neointimal Tissue Characteristics After Drug-Eluting Stent Implantation: Virtual Histology-Intravascular Ultrasound Analysis
Introduction: Patients with chronic kidney disease (CKD) had more mortality, myocardial infarction, repeat revascularization, and bleeding complication after percutaneous coronary intervention compared with those with patients with normal renal function.
Hypothesis: It has been suggested that renal insufficiency may predict cardiovascular events due to an association with more severe coronary artery disease. However, few data are available about neointimal tissue characteristics according to the renal function after drug-eluting stent (DES) implantation. Therefore, the purpose of the present study was to attempt to assess the neointimal tissue components between patients with CKD and those without CKD using virtual histology-intravascular ultrasound (VH-IVUS).
Methods: We compared neointimal tissue components between patients with CKD [n=19, estimated creatinine clearance (CrCl) <60 mL/min) and those without CKD (n=229). The region of interest was placed between the luminal border and the inner border of the stent struts and tissue components were reported as percentages of neointimal volume.
Results: Mean follow-up durations between DES implantation and follow-up VH-IVUS study were 12.0±4.1 months in CKD group and 11.4±5.6 months in non-CKD group (p = 0.519). At follow-up, neointima volume was significantly greater (72±47 mm3 vs. 47±26 mm3, p < 0.001) and %neointima necrotic core (NC) volume was significantly greater (25.0±11.4% vs. 17.9±10.2%, p = 0.012) in CKD group compared with non-CKD group. There was negative correlation between CrCl and neointima volume (r = -0.250, p < 0.001), however, there was no significant correlation between CrCl and %neointima NC volume (r = -0.034, p = 0.591). Only independent predictor of follow-up %neointima NC volume ≥10% was neointima volume (odds ratio 1.025, 95% confidence interval 1.013-1.036, p < 0.001).
Conclusions: Renal function was associated with in-stent neointimal growth, but it was not associated with neointima NC formation, instead the amount of neointima was associated with more neoatherosclerosis in patients who underwent DES implantation.
Author Disclosures: Y. Hong: None. M. Jeong: None. K. Kim: None. M. Kim: None. W. Kim: None. C. Kim: None. K. Lee: None. S. Jun: None. K. Cho: None. H. Kim: None. S. Rhew: None. S. Kim: None. H. Jeong: None. J. Cho: None. K. Lee: None. K. Park: None. D. Sim: None. K. Kim: None. H. Park: None. J. Kim: None. Y. Ahn: None. J. Cho: None. J. Park: None.
- © 2014 by American Heart Association, Inc.