P3577Predictors analysis of restenosis in calcified nodule with OCT-guided PCI

Abstract Background Recent reports show that stenting for coronary calcified nodule (CN) resulted in frequent in-stent restenosis, however, its predictors are unclear. Method 117 consecutive calcified nodule lesions which underwent optical coherence tomography (OCT)-guided PCI were analyzed between January 2013 and March 2018. We investigated baseline characteristics and OCT parameter in CN site (Arc of CN, Lumen area and Symmetry index before and after PCI). Result CN site in-stent restenosis was seen 35 lesions (29.9%). Baseline characteristics was significantly different between restenosis group and non-restenosis group (Age; 68.9y.o vs. 73.3y.o, p=0.01, diabetes mellitus; 80.0% vs. 57.3%, Chronic Kidney Disease (CKD); 74.3% vs. 36.6%, Hemodialysis; 54.3% vs. 12.2%). Arc of CN before PCI in restenosis group was larger than that in non-restenosis group (122.7 vs. 110.0 degrees, p=0.01). Post stent symmetry index in restenosis group was smaller than that in non-restenosis group (0.64 vs. 0.75, p<0.01). Conclusion Younger patients, diabetes mellitus, CKD, hemodialysis, arc of CN before PCI, post stent symmetry index may be predictors of CN site restenosis.

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Abstract 16128: Vascular Healing Response After Everolimus Eluting Stent Implantation in Patients With or Without Diabetes Mellitus -Evaluation With Optical Coherence Tomography

Circulation ◽

10.1161/circ.130.suppl_2.16128 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Yutaka Goryo ◽

Shiro Uemura ◽

Yoko Dote ◽

Yu Sugawara ◽

Tomoya Ueda ◽

...

Keyword(s):

Diabetes Mellitus ◽

Optical Coherence Tomography ◽

Cross Sections ◽

Healing Process ◽

Drug Eluting Stent ◽

Optical Coherence ◽

Cross Sectional ◽

Stent Restenosis ◽

Neointimal Coverage ◽

In Stent Restenosis

Introduction: Clinical introduction of percutaneous coronary intervention (PCI) with drug eluting stent has substantially decreased the rate of in-stent restenosis (ISR). However, it is reported that patients with diabetes mellitus (DM) still have higher incidence of restenosis and secondary cardiovascular events than patients without DM. Using intravascular optical coherence tomography (OCT), we evaluated the effect of DM on healing process of coronary artery after everolimus eluting stents (EES) implantation in the comparison with non-DM patients. Methods and Results: We studied 26 DM patients (65.1±11.9y/o) and 59 non-DM patients (68.1±9.4y/o) who received OCT-guided EES implantation. The second OCT examination was performed on 296±71.1 days after implantation (291±74.2days vs. 298±70.3days, p=0.51). OCT cross-sectional images of the second study were examined to determine the condition of neointimal coverage over every strut in 1mm interval (DM; 725 cross-sections and 5742 struts, non-DM; 1482 cross-sections and 12098 struts). In addition, neointimal thickness (NIT) over each strut measured and tissue characteristics were examined. One in-stent restenosis with clinical manifestation was observed in each group. Average NIT was significantly thicker in DM group than in non-DM group (107±99.2μm vs. 92±74.6μm, p<0.01). The incidence of malapposed struts without neointimal coverage were very low and similar in both groups (0.22±0.54 vs. 0.13±0.72%, p=0.43). The frequency of OCT-defined unstable neointimal characteristics was significantly higher rate in DM than non-DM group (14.5±18.9% vs. 6.67±14.5%, p=0.03). Conclusions: EES implanted in DM patients showed acceptable neointimal proliferation and uncovered stent struts similar to non-DM patients, suggesting the mid-term efficacy and safety of EES in DM patients. However, long-term follow-up should be necessary because of the high incidence of unstable neointimal characteristics which might be a substrate for the future development of neoatherosclerosis.

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Downregulation of AnnexinA5 Gene Expression in Coronary In-Stent Restenosis – A Pilot Study

10.21203/rs.3.rs-459120/v1 ◽

2021 ◽

Author(s):

Mojtaba Baktashian ◽

Sara Saffar Soflaei ◽

Mansoor Salehi ◽

Mohsen Moohebati ◽

Omid Iravani ◽

...

Keyword(s):

Gene Expression ◽

Diabetes Mellitus ◽

Housekeeping Gene ◽

Taqman Probe ◽

Stent Restenosis ◽

Coronary Stent Implantation ◽

History Of ◽

Baseline Characteristics ◽

Commercial Kits ◽

In Stent Restenosis

Abstract Background and aims: In- stent restenosis (ISR) is the Achilles heel of angioplasty. AnnexinA5 as an anticoagulant has been shown have anti-inflammatory and anti-atherosclerotic effects. Here we aim to investigating the mRNA expression of AnnexinA5 in peripheral white blood cell of patients with in-stent restenosis. Methods Patients with the history of coronary stent implantation who candidate for re-angiography were entered the study and allocated into two groups according the results of re-angiography; in-stent restenosis (stenosis ≥ 50% in stent) and non-in-stent restenosis (stenosis < 50% in stent). Total RNA of WBC was extracted and cDNA was synthesized using commercial kits. AnnexinA5 expression was assessed with real time PCR and TaqMan probe and reported in relation with GAPDH as a housekeeping gene. Result AnnexinA5 expression was investigated in total 50 participants including 25 ISR and 25 non-ISR. Baseline characteristics including age, sex, smoking habits, hypertension, diabetes mellitus, dyslipidemia and stent in LAD were statistically the same in cases and controls. AnnexinA5 expression in ISR patients was 50% lower than controls. Conclusion AnnexinA5 is down-regulated in ISR and could be considered as a biomarker for predicting ISR and furthermore it could be used as prevention for ISR occurrence.

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