Coronary risk factors associated with OCT macrophage images and their response after CoCr everolimus-eluting stent implantation in patients with stable coronary artery disease

Atherosclerosis. 2017 Oct:265:117-123. doi: 10.1016/j.atherosclerosis.2017.08.002. Epub 2017 Aug 18.

Abstract

Background and aims: The aim of this study was to evaluate the accumulation of optical coherence tomography (OCT)-macrophages and OCT findings after CoCr everolimus-eluting stent placement, in addition to coronary risk factors.

Methods: A total of 89 lesions in 89 patients were registered in the 1- and 3-month cohort of the multi-centre study. Lesion characteristics and post-procedure OCT images were evaluated immediately and 1 and 3 months after stenting. Patients were divided into low and high macrophage grade groups based on the median macrophage grade.

Results: Low-density lipoprotein cholesterol (LDL-C) levels, the prevalence of diabetes mellitus, HbA1c and blood glucose levels in the high macrophage grade group were significantly higher than in the low macrophage grade group (p = 0.025, p = 0.040, p = 0.032, and p = 0.010). Moreover, total lipid arc and length and number of thin-cap fibroatheromas (TCFAs) in the high macrophage grade group were significantly higher than in the low macrophage group (p = 0.008, p = 0.002, and p = 0.012). After CoCr everolimus-eluting stenting, there was a trend towards a greater number, height, and area of irregular protrusions in the high macrophage grade group compared to the low macrophage grade group (p = 0.091, p = 0.059, and p = 0.085). Multivariate logistic regression analysis showed that diabetes mellitus was a significant predictor of high macrophage grades (odds ratio: 2.8, 95% CI: 1.1-7.3, p = 0.030).

Conclusions: The accumulation of OCT-macrophages was associated with diabetes mellitus in patients with coronary artery disease. Moreover, macrophage accumulation and diabetes mellitus may be associated with irregular protrusions just after stenting.

Keywords: Cobalt chromium everolimus-eluting stent; Coronary artery disease; Diabetes mellitus; Irregular protrusion; Macrophage; Optical coherence tomography.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Cardiovascular Agents / administration & dosage*
  • Cardiovascular Agents / adverse effects
  • Chi-Square Distribution
  • Cholesterol, LDL / blood
  • Chromium Alloys*
  • Comorbidity
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / pathology
  • Coronary Artery Disease / therapy*
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / metabolism
  • Coronary Vessels / pathology
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology
  • Drug-Eluting Stents*
  • Everolimus / administration & dosage*
  • Everolimus / adverse effects
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Japan / epidemiology
  • Logistic Models
  • Macrophages / metabolism
  • Macrophages / pathology*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Predictive Value of Tests
  • Prevalence
  • Prosthesis Design
  • Registries
  • Risk Factors
  • Time Factors
  • Tomography, Optical Coherence*
  • Treatment Outcome

Substances

  • Biomarkers
  • Blood Glucose
  • Cardiovascular Agents
  • Cholesterol, LDL
  • Chromium Alloys
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human
  • Everolimus