Predictors for the Early Development of Neoatherosclerosis After Newer-generation Drug-eluting Stent Implantation

Abstract

Several clinical trials have found that percutaneous coronary intervention (PCI) using drug-eluting stents (DESs) drastically improve the clinical outcome 1,2) . However, the development of neoatherosclerosis (NA) after DES implantation has been a recent clinical problem in PCI, even when using second-or third-generation DESs [3][4][5] . Several clinical trials have reported predictors for the late development of NA after stent implantation 6) . However, predictors for the early development of NA with second-and third-generation DESs remain unclear.Optical coherence tomography (OCT) has a 10-fold higher resolution than intravascular ultrasound (IVUS) and can allow the detailed assessment of the characteristics of lesion plaques or in-stent tissue protrusions. Furthermore, irregular in-stent protrusion (IP) after stent implantation has been reported to be associated with adverse cardiac events 7) .In the present study, we explored the predictive fi ndings for the early development of NA after newer-generation DES implantation by comparing serial OCT fi ndings. II. Methods 1. Patient population From among 1,296 consecutive patients who underwent PCI in our institution from December 2015 and August 2018, we enrolled 123 consecutive patients (140 lesions) with second-and third-generation DESs with available fi ndings for both pre-and post-stenting OCT and who had undergone eight-month follow-up OCT. OCT-guided PCI was indicated if approved by both