title: Comparison of Neoatherosclerosis and Neovascularization Between Patients With and Without Diabetes: An Optical Coherence Tomography Study.
abstract: OBJECTIVE
  This study aimed to investigate the characteristics of neoatherosclerosis (NA) in patients with diabetes mellitus (DM) after drug-eluting stent (DES) implantation using optical coherence tomography.
  
  
  BACKGROUND
  NA is an important substrate for stent failure. In vivo NA characteristics in DM patients have not been investigated.
  
  
  METHODS
  A total of 397 patients with 452 DES who underwent follow-up optical coherence tomography examination after DES implantation were enrolled. Characteristics of NA were compared between DM and non-DM patients. Neovascularization was defined as signal-poor holes or tubular structures with a diameter of 50 to 300 μm.
  
  
  RESULTS
  A total of 123 DES with NA lesions in 115 patients were identified. The incidence of NA was similar between DM and non-DM patients (29.6% vs. 28.6%; p = 0.825). Compared with the non-DM group, neovascularization was more frequently observed in the DM group (55.1% vs. 32.4%; p = 0.012). The multivariate logistic model demonstrated that DM (odds ratio: 3.00; 95% confidence interval: 1.31 to 6.81; p = 0.009) and follow-up duration (odds ratio: 1.03; 95% confidence interval: 1.02 to 1.05; p < 0.001) were the independent predictors for neovascularization in NA lesions. DM patients with glycated hemoglobin ≥7.0% had a higher prevalence of thin-cap fibroatheroma compared with those with glycated hemoglobin <7.0% (40.0% vs. 8.3%; p = 0.01).
  
  
  CONCLUSIONS
  The incidence of NA was similar between patients with and without DM. Neovascularization in NA lesions was more frequent in those with DM. Poorly controlled DM patients had a higher incidence of thin-cap fibroatheroma, compared with those with well-controlled DM.
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Lei
authors.initials: L
authors.lastname: Gao
authors.affiliation: Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.affiliation: Queen Mary Hospital, Hong Kong University, Hong Kong.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Kyung-Hee University, Seoul, South Korea.
authors.forename: Chong-Jin
authors.initials: CJ
authors.lastname: Kim
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Minami
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ong
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; The First Department of Medicine, Nara Medical University, Nara, Japan.
authors.forename: Tsunenari
authors.initials: T
authors.lastname: Soeda
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Rocco
authors.initials: R
authors.lastname: Vergallo
authors.affiliation: Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Hang
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
authors.affiliation: The First Department of Medicine, Nara Medical University, Nara, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Uemura
authors.affiliation: Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Division of Cardiology, Kyung-Hee University, Seoul, South Korea. Electronic address: IJANG@mgh.harvard.edu.
authors.forename: Ik-Kyung
authors.initials: IK
authors.lastname: Jang
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005355:Fibrosis; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009389:Neovascularization, Pathologic; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: atherosclerosis; diabetes mellitus; drug-eluting stent