title: Spatial heterogeneity of neoatherosclerosis and its relationship with neovascularization and adjacent plaque characteristics: optical coherence tomography study.
abstract: BACKGROUND
  Development of neoatherosclerosis (NA) has been reported to be a potential cause of late stent failure. However, the distribution of NA and its relationship with neovascularization (NV) and adjacent plaque characteristics remain unclear.
  
  
  METHODS
  We investigated 167 stents (40 bare-metal stents, 84 sirolimus-eluting stents, and 43 everolimus-eluting stents) with optical coherence tomography. Each stent was divided into the proximal section (PS), mid section (MS) and distal section (DS). Neoatherosclerosis was defined as lipid-laden neointima or calcification inside stent. Adjacent plaque characteristics were evaluated within 5 mm proximal and distal reference segments.
  
  
  RESULTS
  Neoatherosclerosis was more frequent in PS and DS than in MS (PS 19.8% vs. MS 3.6% vs. DS 21%: PS vs. MS, P < .001: MS vs. DS, P < .001). Neovascularization in PS and DS was also more prevalent compared with that in MS (PS 15% vs. MS 5.4% vs. DS 13.8%: PS vs. MS, P = .001: MS vs. DS, P = .001). Neoatherosclerosis was more frequently observed in stents with intraintima NV (68.6% vs. 20.5%, P < .001). The incidence of NA was higher, when adjacent plaque was lipid (43.2% with lipid plaque vs. 12.2% without lipid plaque, P < .001).
  
  
  CONCLUSIONS
  Neoatherosclerosis occurs more frequently at PS and DS. Neoatherosclerosis was associated with NV and adjacent lipid plaque, suggesting potential interrelationship between development of NA and NV and adjacent plaque characteristics.
authors.affiliation: Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University; the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Jinwei
authors.initials: J
authors.lastname: Tian
authors.affiliation: Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University; the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Ren
authors.affiliation: Nara Medical University, Nara, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.affiliation: University of Vermont, Fletcher Allen Healthcare, Burlington, VT.
authors.forename: Harold
authors.initials: H
authors.lastname: Dauerman
authors.affiliation: Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Abhiram
authors.initials: A
authors.lastname: Prasad
authors.affiliation: University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Catalin
authors.initials: C
authors.lastname: Toma
authors.affiliation: Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University; the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Haibo
authors.initials: H
authors.lastname: Jia
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Farhad
authors.initials: F
authors.lastname: Abtahian
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Rocco
authors.initials: R
authors.lastname: Vergallo
authors.affiliation: Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University; the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China; Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Sining
authors.initials: S
authors.lastname: Hu
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Iris
authors.initials: I
authors.lastname: McNulty
authors.affiliation: Biostatistics, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
authors.forename: Hang
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Medicine, Queen Mary Hospital, Hong Kong University, Hong Kong, China.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Cardiology, the 2nd Affiliated Hospital of Harbin Medical University; the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China. Electronic address: yubodr@163.com.
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: ijang@partners.org.
authors.forename: Ik-Kyung
authors.initials: IK
authors.lastname: Jang
mesh_terms: D000368:Aged; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000473:pathology; D023903:Coronary Restenosis / Q000175:diagnosis* / Q000473:pathology; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058426:Neointima / Q000175:diagnosis / Q000473:pathology; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000473:pathology; D058226:Plaque, Atherosclerotic / Q000175:diagnosis* / Q000473:pathology; D011475:Prosthesis Failure; D020123:Sirolimus; D015607:Stents; D041623:Tomography, Optical Coherence
chemical_list: D020123:Sirolimus