title: Relation between renal function and neointimal tissue characteristics after drug-eluting stent implantation: virtual histology-intravascular ultrasound analysis.
abstract: BACKGROUND
  Few data are available about neointimal tissue characteristics after drug-eluting stent (DES) implantation in patients with decreased renal function. We used virtual histology-intravascular ultrasound (VH-IVUS) to assess the neointimal tissue characteristics according to the baseline renal function.
  
  
  METHODS
  We compared neointimal tissue components between patients with chronic kidney disease (CKD) [n=19, estimated creatinine clearance (CrCl) <60mL/min] and those without CKD (n=229). The region of interest was placed between the luminal border and the inner border of the stent struts and tissue components were reported as percentages of neointimal volume.
  
  
  RESULTS
  Mean follow-up durations between DES implantation and follow-up VH-IVUS study were 12.0±4.1 months in the CKD group and 11.4±5.6 months in the non-CKD group (p=0.519). At follow-up, neointima volume was significantly greater (72±47mm(3) vs. 47±26 mm(3), p<0.001) and %neointima necrotic core (NC) volume was significantly greater (25.0±11.4% vs. 17.9±10.2%, p=0.012) in the CKD group compared with the non-CKD group. There was negative correlation between CrCl and neointima volume (r=-0.250, p<0.001), however, there was no significant correlation between CrCl and %neointima NC volume (r=-0.034, p=0.591). The only independent predictor of follow-up %neointima NC volume ≥10% was neointima volume (odds ratio 1.025, 95% confidence interval 1.013-1.036, p<0.001).
  
  
  CONCLUSIONS
  Renal function was associated with in-stent neointimal growth, but it was not associated with neointima NC formation. Instead, the amount of neointima was associated with more neoatherosclerosis in patients who underwent DES implantation.
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea. Electronic address: myungho@chollian.net.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Yun Ha
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Park
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Si Hyun
authors.initials: SH
authors.lastname: Rhew
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Young Wook
authors.initials: YW
authors.lastname: Jeong
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Hae Chang
authors.initials: HC
authors.lastname: Jeong
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Jae Yeong
authors.initials: JY
authors.lastname: Cho
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Jang
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Ki Hong
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Keun Ho
authors.initials: KH
authors.lastname: Park
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Nam Sik
authors.initials: NS
authors.lastname: Yoon
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Yoon
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.affiliation: Heart Center of Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003404:Creatinine; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D058426:Neointima / Q000000981:diagnostic imaging* / Q000473:pathology*; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology*; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D003404:Creatinine
keywords: Chronic kidney disease; Intravascular ultrasound; Neointima; Restenosis