Renal Dysfunction and Atherosclerosis of the Neointima following Bare Metal Stent Implantation
| Autor: | Junji Watanabe, Hideki Ishii, Daiji Yoshikawa, Toyoaki Murohara, Tatsuaki Matsubara, Susumu Suzuki, Masaaki Kanashiro, Satoshi Ichimiya, Kengo Maeda, Shinji Hayano |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Bare-metal stent Neointima medicine.medical_specialty medicine.medical_treatment Coronary Artery Disease Coronary Angiography Coronary Restenosis Percutaneous Coronary Intervention Restenosis Internal medicine Intravascular ultrasound medicine Humans Prospective Studies Renal Insufficiency Chronic Ultrasonography Interventional Aged medicine.diagnostic_test business.industry Stent Middle Aged medicine.disease Coronary Vessels Logistic Models Nephrology Cardiology Female Stents business Glomerular Filtration Rate |
| Zdroj: | American Journal of Nephrology. 38:58-65 |
| ISSN: | 1421-9670 0250-8095 |
| DOI: | 10.1159/000353097 |
| Popis: | Background: Recently, neoatherosclerosis within the neointima after bare metal stent (BMS) implantation, which could cause late restenosis and very late stent thrombosis, has been a cause of concern. Renal dysfunction has been related to late cardiovascular events after coronary intervention. The present study was conducted focusing on the relationship between renal dysfunction and neointimal tissue characteristics with BMS restenosis using integrated backscatter intravascular ultrasound (IB-IVUS). Methods: We prospectively performed IB-IVUS in 80 consecutive patients requiring target lesion revascularization after BMS implantation; the patients were divided into two groups according to the estimated glomerular filtration [eGFR: ≥60 (n = 49) and 2 (n = 31)]. Results: Patients with eGFR 2 had a significantly higher percentage of lipid tissue volume within the neointima and a lower percentage of fibrous tissue volume than those with eGFR ≥60 ml/min/1.73 m2 (23.2 ± 9.4 vs. 18.0 ± 7.0%, p = 0.005, and 75.3 ± 9.3 vs. 80.4 ± 7.0%, p = 0.007, respectively). Using logistic regression analysis, eGFR 2 and duration from stent implantation ≥48 months were independent predictors of increased lipid tissue volume within the neointima (odds ratio, 3.93; 95% confidence interval, 1.15-13.46, p = 0.03, and odds ratio, 7.56; 95% confidence interval, 2.02-28.30, p = 0.003, respectively). Conclusions: Lower eGFR levels were associated with greater lipid tissue volume within the neointima after BMS deployment, suggesting the development of atherosclerosis. Renal dysfunction may affect neointimal tissue characteristics and thus leading to an increased risk of late stent failure. |
| Databáze: | OpenAIRE |
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