Association between asymmetric dimethylarginine and in-stent restenosis tissue characteristics assessed by optical coherence tomography

Autor: Chien-Hung Hsueh, William Kongto Hau, Wei-Chieh Huang, Hsin-I Teng, Tse-Min Lu, Ying-Ying Chen, Chuan-Tsai Tsai, Hsiang-Yao Chen, Ching-Ju Wu
Rok vydání: 2018
Předmět:
Neointima
Male
medicine.medical_specialty
Time Factors
030204 cardiovascular system & hematology
Arginine
Coronary Angiography
Nitric oxide
Pathogenesis
Coronary Restenosis
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Percutaneous Coronary Intervention
Optical coherence tomography
Restenosis
Risk Factors
Internal medicine
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Prospective Studies
Endothelial dysfunction
Aged
medicine.diagnostic_test
business.industry
Drug-Eluting Stents
Middle Aged
medicine.disease
Coronary Vessels
Plaque
Atherosclerotic
Prosthesis Failure
chemistry
Cardiology
Female
Cardiology and Cardiovascular Medicine
Asymmetric dimethylarginine
business
Biomarkers
Tomography
Optical Coherence
Calcification
Follow-Up Studies
Zdroj: International journal of cardiology. 289
ISSN: 1874-1754
Popis: Impaired bioavailability of endothelium-derived nitric oxide (NO) and endothelial dysfunction may play a pivotal role in the pathogenesis of in-stent restenosis (ISR) after coronary stenting. We aimed to investigate the relation between asymmetric dimethylarginine (ADMA), an endogenous NO synthase inhibitor, and the ISR lesions tissue characteristics assessed by optical coherence tomography (OCT).Forty-five patients with symptomatic ISR lesions (17 bare metal stents, 28 drug-eluting stents, medium implantation duration: 58.0 months) were evaluated by OCT for in-stent tissue characteristics and calcification. We defined neoatherosclerosis as the presence of lipid or calcified neointima in ISR lesions, and 12 (26.7%), 33 (73.3%) ISR lesions were classified as with homogenous neointima and neoatherosclerosis respectively. The patients with neoatherosclerosis have significantly higher plasma ADMA levels compared to those of patients with homogenous neointima (1.12 ± 0.21 μmol/l versus 0.83 ± 0.08 μmol/l, p 0.001). Furthermore, the plasma ADMA level of ISR lesions with intra-stent calcification (n = 24, 53.3%) was also significantly higher than those of ISR lesions without (n = 21, 46.7%; p 0.001). There was a highly significant association between plasma ADMA level and intra-stent relative calcium index (mean calcium arc × calcium length)/(360 × analyzed length) (p 0.001, r = 0.702). In multivariate analyses adjusted for age, sex, diabetes, eGFR, plasma ADMA level remained the only significant predictor for the presence of neoatherosclerosis (p = 0.008) and intra-stent calcification (p 0.001). In contrast, plasma ADMA level correlated with intra-stent relative lipid core index (mean lipid core arc × lipid core length)/(360 × analyzed length) only in subgroup without intra-stent calcification (p = 0.004, r = 0.596, multivariate-adjusted p = 0.022).Increased plasma ADMA levels were associated with the development of in-stent neoatherosclerosis and calcification.
Databáze: OpenAIRE
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