In-stent restenosis-prone coronary plaque composition: A retrospective virtual histology-intravascular ultrasound study

• Published in: Cardiology journal Vol. 25; no. 1; pp. 7 - 13
• Main Authors: Seo, Duck-Jun, Kim, Yong-Kyun, Seo, Young-Hoon, Song, In-Geol, Kim, Ki-Hong, Kwon, Taek-Geun, Park, Hyun-Woong, Bae, Jang-Ho
• Format: Journal Article
• Language: English
• Published: Poland Wydawnictwo Via Medica 01.01.2018
• Subjects: Aged; Coronary Angiography; Coronary Restenosis - diagnostic imaging; Coronary Restenosis - etiology; Coronary Restenosis - surgery; Coronary Vessels - diagnostic imaging; Coronary Vessels - surgery; Female; Histology; Humans; Male; Middle Aged; Percutaneous Coronary Intervention; Plaque, Atherosclerotic - complications; Plaque, Atherosclerotic - diagnostic imaging; Plaque, Atherosclerotic - surgery; Retrospective Studies; Stents; Ultrasonic imaging; Ultrasonography, Interventional - methods; coronary artery disease; coronary stenosis; myocardial ischemia; inflammation; intravascular ultrasonography
• ISSN: 1897-5593; 1897-5593; 1898-018X
• DOI: 10.5603/CJ.a2017.0124

The mechanism of in-stent restenosis (ISR) is multifactorial, which includes biological, mechanical and technical factors. This study hypothesized that increased inflammatory reaction, which is known to be an important atherosclerotic process, at a culprit lesion may lead to higher restenosis rates. The study population consisted of 241 patients who had undergone percutaneous coronary intervention with virtual histology-intravascular ultrasound (VH-IVUS) and a 9-month follow-up coronary angiography. Compared herein is the coronary plaque composition between patients with ISR and those without ISR. Patients with ISR (n = 27) were likely to be older (66.2 ± 9.5 years vs. 58.7 ± 11.7 years, p = 0.002) and have higher levels of high-sensitivity C-reactive protein (hs-CRP, 1.60 ± 3.59 mg/dL vs. 0.31 ± 0.76 mg/dL, p < 0.001) than those without ISR (n = 214). VH-IVUS examination showed that percent necrotic core volume (14.3 ± 8.7% vs. 19.5 ± 9.1%, p = 0.005) was higher in those without ISR than those with ISR. Multivariate analysis revealed that hs-CRP (odds ratio [OR] 3.334, 95% con-fidence interval [CI] 1.158-9.596, p = 0.026) and age (OR 3.557, 95% CI 1.242-10.192, p = 0.018) were associated with ISR. This study suggests that ISR is not associated with baseline coronary plaque composition but is associated with old age and increased expression of the inflammatory marker of hs-CRP. (Cardiol J 2018; 25, 1: 7-13).