Preprocedural inflammation does not affect neointimal hyperplasia following everolimus-eluting stent implantation.
BACKGROUND
Preprocedual C-reactive protein (CRP) has been reported to correlate with in-stent restenosis following bare-metal stent implantation. The aim of this study was to investigate the impact of preprocedural inflammation on neointimal hyperplasia assessed by intravascular ultrasound (IVUS) following everolimus-eluting stent (EES) implantation.


METHODS
We identified 134 patients meeting the following criteria: 1) patients treated with EES; 2) those with stable or unstable angina; and 3) patients available for high-sensitivity (hs)-CRP before the procedure and volumetric IVUS analysis at follow up. We divided the patients into two groups on the basis of hs-CRP levels (< 3 or > or = 3 mg/L) before the procedure and compared IVUS parameters. Volume index (volume/length) was calculated for vessel (VVI), plaque (PVI), neointima (NIV), stent (SVI), and lumen (LVI). Percent neointimal volume (%NIV) was calculated as (NIV/SVI) x 100. Cross-sectional narrowing (CSN) was defined as neointimal area divided by stent area (%).


RESULTS
There was no significant difference in VVI, PVI, or LVI at either baseline or 8-month follow up between the two groups. At 8-month follow up, there was also no significant difference in %NIV (4.93 +/- 5.66% vs. 4.98 +/- 5.25% p = 0.959) and maximum %CSN (16.81 +/- 13.62% vs. 18.14 +/- 13.91%; p = 0.608) as well as VVI, PVI, and LVI between the two groups. Furthermore, hs-CRP did not correlate with %NIV (r = 0.044; p = 0.610) and maximum %CSN (r = 0.086, p = 0.321) at follow up. There was no significant difference in incidence of late-acquired incomplete stent apposition between the two groups (1.2% vs. 0%; p = 0.512).


CONCLUSIONS
Our results suggest that preprocedural inflammation does not affect neointimal hyperplasia following EES implantation.
Nakatani
Daisaku
D
Stanford University, California 94305, USA.
Ako
Junya
J
Yamasaki
Masao
M
Shimohama
Takao
T
Hasegawa
Takao
T
Otake
Hiromasa
H
Waseda
Katsuhisa
K
Tsujino
Ichizo
I
Sakurai
Ryota
R
Koo
Bon-Kwon
BK
Chang
Hyeonsoo
H
Yock
Paul G
PG
Sudhir
Krishnankutty
K
Pierson
Wesley
W
Stone
Gregg W
GW
Saito
Shigeru
S
Honda
Yasuhiro
Y
Fitzgerald
Peter J
PJ
D000368:Aged; D000789:Angina, Unstable / Q000503:physiopathology / Q000628:therapy; D002097:C-Reactive Protein / Q000378:metabolism; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia / Q000000981:diagnostic imaging / Q000473:pathology; D007166:Immunosuppressive Agents; D007249:Inflammation / Q000097:blood / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000031:analogs & derivatives*; D017539:Tunica Intima / Q000000981:diagnostic imaging* / Q000473:pathology*; D018084:Ultrasonography, Interventional
D007166:Immunosuppressive Agents; D002097:C-Reactive Protein; D000068338:Everolimus; D020123:Sirolimus