Author + information
- Received December 3, 2014
- Revision received January 21, 2015
- Accepted February 12, 2015
- Published online July 1, 2015.
- Lei Gao, MD, PhD∗,
- Seung-Jung Park, MD, PhD†,
- Yangsoo Jang, MD, PhD‡,
- Stephen Lee, MD§,
- Chong-Jin Kim, MD, PhD‖,
- Yoshiyasu Minami, MD, PhD∗,
- Daniel Ong, MD∗,
- Tsunenari Soeda, MD, PhD∗,¶,
- Rocco Vergallo, MD∗,
- Hang Lee, PhD#,
- Bo Yu, MD, PhD∗∗,
- Shiro Uemura, MD, PhD¶ and
- Ik-Kyung Jang, MD, PhD∗,‖∗ ()
- ∗Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- †Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
- ‡Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea
- §Queen Mary Hospital, Hong Kong University, Hong Kong
- ‖Division of Cardiology, Kyung-Hee University, Seoul, South Korea
- ¶The First Department of Medicine, Nara Medical University, Nara, Japan
- #Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- ∗∗Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
- ↵∗Reprint requests and correspondence:
Dr. Ik-Kyung Jang, Cardiology Division, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRB 800, Boston, Massachusetts 02114.
Objectives This study aimed to investigate the characteristics of neoatherosclerosis (NA) in patients with diabetes mellitus (DM) after drug-eluting stent (DES) implantation using optical coherence tomography.
Background NA is an important substrate for stent failure. In vivo NA characteristics in DM patients have not been investigated.
Methods A total of 397 patients with 452 DES who underwent follow-up optical coherence tomography examination after DES implantation were enrolled. Characteristics of NA were compared between DM and non-DM patients. Neovascularization was defined as signal-poor holes or tubular structures with a diameter of 50 to 300 μm.
Results A total of 123 DES with NA lesions in 115 patients were identified. The incidence of NA was similar between DM and non-DM patients (29.6% vs. 28.6%; p = 0.825). Compared with the non-DM group, neovascularization was more frequently observed in the DM group (55.1% vs. 32.4%; p = 0.012). The multivariate logistic model demonstrated that DM (odds ratio: 3.00; 95% confidence interval: 1.31 to 6.81; p = 0.009) and follow-up duration (odds ratio: 1.03; 95% confidence interval: 1.02 to 1.05; p < 0.001) were the independent predictors for neovascularization in NA lesions. DM patients with glycated hemoglobin ≥7.0% had a higher prevalence of thin-cap fibroatheroma compared with those with glycated hemoglobin <7.0% (40.0% vs. 8.3%; p = 0.01).
Conclusions The incidence of NA was similar between patients with and without DM. Neovascularization in NA lesions was more frequent in those with DM. Poorly controlled DM patients had a higher incidence of thin-cap fibroatheroma, compared with those with well-controlled DM.
Dr. Jang has received a research grant and honorarium from St. Jude Medical; and has received research grants from Boston Scientific and Medtronic. Dr. Vergallo was funded in part by the 2013 Italian Society of Cardiology Award for Research Abroad. Dr. Yu has received a grant from the National Natural Science Foundation of China (30871064). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received December 3, 2014.
- Revision received January 21, 2015.
- Accepted February 12, 2015.
- 2015 American College of Cardiology Foundation