Impact of Pre-Stent İmplantation Plaque Burden on the Development of Stent Restenosis

Abstract

Aim: In this study we have used quantitative coronary angiography (QCA) and the Image J program in order to investigate the influence of plaque area, as identified prior to stent implantation, on the development of stent restenosis. Material and Method: 5180 coronary angiography procedures were performed between March 2008 and July 2011. Of these, 227 presented with in-stent restenosis. After application of the exclusion criteria, 164 intracor-onary stents implanted in 121 patients were retrospectively investigated. These stents were divided into two groups depending upon the clinical status of the patient: (a) those who developed in-stent restenosis (n: 77, 47%), and (b) those who failed to develop in-stent restenosis (n: 87, 53%). Narrowing by 50% or more, as identified during coronary angiography performed at least six months after the stent implantation, was considered as positive for development of in-stent restenosis. Plaque area measurement in the patients was performed using quantitative coronary angiography (QCA) and the Image J program. Results: Plaque area measurement when performed quantitatively revealed no statistically significant difference between the groups (p>0.05). However, significant difference in area was observed when Image J was used (p<0.05). Statistically significant differences were observed between groups in terms of history of hypertension and hyperlipidemia, use of statins, HDL values, and lesion type (p<0.05); the difference in terms of presence of diabetes or smoking status (p>0.05) was not significant. There was a relationship among the development of restenosis and hypertension, non-usage of statin therapy, HDL level, poor lesion type, and plaque area as measured with Image J. Discussion: Hypertension, non-usage statin therapy, low levels of HDL, poor lesion type, and larger plaque areas as measured with the Image J program were identified as important indicators for development of in-stent restenosis. © Derman Medical Publishing. All rights reserved.