title: Impact of Age on Stent Strut Coverage and Neointimal Remodeling as Assessed by Optical Coherence Tomography.
abstract: While older age associates with adverse percutaneous coronary intervention (PCI) outcomes, detailed information relating age to stent strut coverage and neointimal characteristics is lacking. One hundred nineteen patients with 123 sirolimus-eluting stents (SESs) were divided into 3 groups: group A (≤55 years), group B (56-65 years), and group C (>65 years). At 6 and 12 months of follow-up, optical coherence tomography was performed to assess strut coverage and neointimal remodeling. At 6 months, the proportion of uncovered struts increased with age: 6.1% in group A versus 7.3% in group B versus 11.7% in group C (P < 0.001) while the proportion of embedded struts decreased: 72.1% versus 57.0% vs. 55.0%, respectively (P < 0.001). Mean neointimal thicknesses were 90  μm versus 60  μm versus 60  μm, respectively (P < 0.001), and neointimal areas were 0.82  mm2 versus 0.52  mm2 versus 0.57  mm2 (P < 0.001). At 12 months, the proportion of uncovered struts increased with age (3.9% vs. 3.3% vs. 4.9 %; P < 0.001), while mean neointimal thicknesses were 100 versus 70 versus 80  μm (P < 0.001) and neointimal areas were 0.87 versus 0.60 versus 0.67  mm2 (P < 0.001). Patients ≤55 years receiving SES showed highest strut coverage and neointimal repair rate compared with the other 2 groups. A "catch-up phenomenon" appeared to occur in the oldest patients, as in the first 6 months the neointima showed lowest endothelial cell coverage and lowest neointimal proliferation rate, whereas from 6 to 12 months, the highest neointimal proliferation rate was seen in the oldest patients.
authors.affiliation: From the Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, P.R. China (SZ); and the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, P.R. China (ZH, LF, HD, ZS, SH, JD, MS, LX, JH, BY).
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Han
authors.forename: Linxing
authors.initials: L
authors.lastname: Feng
authors.forename: Hongwei
authors.initials: H
authors.lastname: Du
authors.forename: Zhao
authors.initials: Z
authors.lastname: Sun
authors.forename: Sining
authors.initials: S
authors.lastname: Hu
authors.forename: Jiannan
authors.initials: J
authors.lastname: Dai
authors.forename: Meng
authors.initials: M
authors.lastname: Sun
authors.forename: Lei
authors.initials: L
authors.lastname: Xing
authors.forename: Jingbo
authors.initials: J
authors.lastname: Hou
authors.forename: Shaosong
authors.initials: S
authors.lastname: Zhang
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
mesh_terms: D000367:Age Factors; D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents; D008297:Male; D008875:Middle Aged; D058426:Neointima / Q000175:diagnosis* / Q000209:etiology; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies; D020123:Sirolimus; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D066253:Vascular Remodeling / Q000502:physiology*
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus