title: Coronary plaque response after drug eluting stent implantation assessed by serial optical coherence tomography analysis.
abstract: BACKGROUND
  In general, percutaneous coronary intervention (PCI) relieves vessel stenosis by implantation of a stent, however, the relationship between plaque characteristics and response after stenting is not clear.
  
  
  METHODS
  We enrolled 68 patients (68 vessels) with diagnosed unstable angina pectoris that prospectively underwent PCI and an optical coherence tomography (OCT) examination was done before and after stenting. Coronary plaques were classified as fibrous, lipid-rich and calcified plaque according to OCT examination, and fibrous cap thickness, lumen eccentricity, stent expansion, stent malapposition, tissue prolapse, thrombosis, dissection and stent symmetry were noted.
  
  
  RESULTS
  The frequency of prolapse was higher in lipid-rich plaques than fibrous plaques (85% vs. 40%, P < 0.001). Dissection most often occurred in fibrous plaque compared with lipid-rich and calcified plaques (60% vs. 32% vs. 29%, P < 0.001). The frequency of stent strut malapposition in calcified plaques was higher than firous and lipid-rich plaques (71% vs. 40% vs. 5%, P < 0.001). In-stent micro-thrombosis was detected only in lipid-rich plaques, with a frequency of 37% (15/41). The risk factors of micro-thrombosis after PCI were cap thickness (OR 0.903, 95%CI 0.829 - 0.985), lumen eccentricity (OR 1.147, 95%CI 1.012 - 1.30), and stent length (OR 1.495, 95%CI 1.032 - 2.166).
  
  
  CONCLUSIONS
  Plaque response after PCI is associated with its characteristics, and of those, micro-thrombosis after stenting in lipid-rich plaques was the most significant finding and can be predicted.
authors.affiliation: Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Tian
authors.forename: Yun-Dai
authors.initials: YD
authors.lastname: Chen
authors.forename: Lian
authors.initials: L
authors.lastname: Chen
authors.forename: Zhi-Jun
authors.initials: ZJ
authors.lastname: Sun
authors.forename: Chang-Fu
authors.initials: CF
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Guo
authors.forename: Qin-Hua
authors.initials: QH
authors.lastname: Jin
authors.forename: Jin-da
authors.initials: JD
authors.lastname: Wang
authors.forename: Lu-Yue
authors.initials: LY
authors.lastname: Gai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D003324:Coronary Artery Disease / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*