title: Correlation of angiographic late loss with neointimal coverage of drug-eluting stent struts on follow-up optical coherence tomography.
abstract: Minimal data have been published on the correlation between angiographic late loss (LL) and incomplete neointimal coverage of struts after drug-eluting stent (DES) implantation. Therefore, we evaluated the relationship between angiographic LL and the percentage of uncovered struts on follow-up optical coherence tomography (OCT) images, in all cross-sections of the lesions. From the OCT registry database, 219 lesions without restenosis after DES implantation were divided into tertiles based on angiographic LL: tertile I (LL ≤ 0.26 mm), tertile II (0.26 < LL < 0.59 mm), and tertile III (≥0.59 mm). Lesions with the percentage of uncovered struts in the highest quartile (≥75th percentile; >6.0%) were defined as highly uncovered; in an independent analysis, lesions without any uncovered strut(s) were defined as completely covered. Higher percentages of uncovered struts were observed in tertile I than in both tertile II and III (10.3 ± 12.8% vs. 4.2 ± 7.4% vs. 2.4 ± 5.1%, respectively; P < 0.001 for I vs. II and I vs. III). Angiographic LL correlated significantly with the percentage of uncovered struts on OCT (r = -0.340, P < 0.001). The best cut-off values of angiographic LL to predict highly uncovered and completely covered lesions were 0.29 mm (area under curves [AUC] = 0.723, P < 0.001) and 0.61 mm (AUC = 0.692, P < 0.001), respectively. Angiographic LL inversely and significantly correlated with the percentage of uncovered struts on OCT after DES implantation.
authors.affiliation: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Byeong-Keuk
authors.initials: BK
authors.lastname: Kim
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058426:Neointima; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012372:ROC Curve; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome