Influence of plaque calcium on neointimal hyperplasia following bare metal and drug-eluting stent implantation.
OBJECTIVE
To examine the influence of vessel wall calcium on neointimal hyperplasia (NIH) following bare metal stent (BMS) and drug-eluting stent (DES) implantation.


BACKGROUND
While procedural complications with coronary stenting in calcified lesions are well reported, little is known about subsequent NIH on plaque calcium following either BMS or DES implantation.


METHODS
In the Study to COmpare REstenosis Rate between QueST and QuaDDS-QP2 (SCORE) trial, 6 months follow-up volumetric intravascular ultrasound data were available for 41 lesions (BMS, 19; DES, 22). NIH thicknesses on superficial, deep, and noncalcified plaque were calculated at every 0.5 mm intervals over the stented segment. Calcified and less-calcified cross-sections were defined as those containing arcs of plaque calcium > or = 90 degrees and < 90 degrees , respectively.


RESULTS
In BMS, mean NIH thickness on both superficial (0.24 +/- 0.23 mm) and deep calcium (0.25 +/- 0.21 mm) was significantly smaller than that of noncalcified plaque (0.31 +/- 0.22 mm) (P < 0.0005). NIH area was significantly smaller in calcified cross-sections compared to less-calcified cross-sections (2.1 +/- 1.2 mm2 vs. 3.1 +/- 1.9 mm2, P < 0.0001). While in contrast, in DES, mean NIH thickness was similar, irrespective of the presence or location of calcium (0.03 +/- 0.05 mm vs. 0.03 +/- 0.06 mm vs. 0.03 +/- 0.05 mm, superficial vs. deep vs. noncalcified plaque, P = NS). NIH area was also similar between calcified and less-calcified cross-sections (0.3 +/- 0.6 mm2 vs. 0.3 +/- 0.6 mm2, P = NS).


CONCLUSIONS
These results suggest that while plaque calcium may influence NIH following BMS implantation, NIH suppression using DES does not appear to be affected by the presence or location of calcium.
Shimada
Yoshihisa
Y
The Division of Cardiovascular Medicine, Stanford University Medical Center, Stanford, California 94305, USA.
Kataoka
Toru
T
Courtney
Brian K
BK
Morino
Yoshihiro
Y
Bonneau
Heidi N
HN
Yock
Paul G
PG
Grube
Eberhard
E
Honda
Yasuhiro
Y
Fitzgerald
Peter J
PJ
D001952:Bridged-Ring Compounds / Q000008:administration & dosage* / Q000627:therapeutic use; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D002986:Clinical Trials as Topic; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D023903:Coronary Restenosis / Q000517:prevention & control; D016503:Drug Delivery Systems; D006801:Humans; D006965:Hyperplasia; D008670:Metals; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D018084:Ultrasonography, Interventional
D001952:Bridged-Ring Compounds; D008670:Metals; C434083:7-hexanoyltaxol