Predominant microvessel proliferation in coronary stent restenotic tissue in patients with diabetes: insights from optical coherence tomography image analysis.

Abstract

BACKGROUND:

Coronary optical coherence tomography (OCT) enables virtual depiction of histological findings of in-stent restenotic tissue. The aim of this study was to investigate the microvessel proliferation within in-stent restenotic tissue and the influence of diabetes mellitus (DM).

METHODS:

We examined 54 in-stent restenotic coronary artery lesions (stenotic area>50%) from 50 consecutive patients including 28 with DM (56%) and 9 insulin-treated DM patients (18%); who underwent coronary time-domain OCT imaging with automatic pull back (1mm/s, 20 frames/s). Microvessels were defined as low-signal cavities with a diameter of 50-150 microns and a trajectory parallel to the lumen recognized on 3 consecutive cross-sectional OCT image frames. The microvessel index was calculated as the number of frames with microvessel/total number of frames × 100. Patients were stratified into 3 groups: 1) without microvessels, 2) with a low (< median value) microvessel index, 3) with a high microvessel index.

RESULTS:

Microvessels were detected in 566 frames (3.1%) from 26 lesions (48%) in 24 patients (48%). A greater incidence of DM and higher serum glucose levels were observed in the high microvessel index group (DM: 42% vs 58% vs 83%, p=0.049; serum glucose level: 118.2 ± 44.6 vs 122.6 ± 31.0 vs 172.8 ± 63.1mg/dL, p=0.03 between low and high microvessel index group, p=0.005 between no microvessel and high microvessel index group).

CONCLUSIONS:

Microvessel formation may be a unique pathophysiological factor of in-stent restenoses in patients with DM.

• Authors: Nobuaki Suzuki, Ken Kozuma, Hiroyuki Kyono, Shuji Otsuki, Qiang Fu, Naoyoshi Hosogoe, Tomohisa Saito, Kazuya Naito, Mina Ochiai, Shuichi Ishikawa, Hidenori Watanabe, Akiyoshi Miyazawa, Kazuhiro Eto, Takaaki Isshiki
• Journal: International journal of cardiology (Int J Cardiol) Vol. 168 Issue 2 Pg. 843-7 (Sep 30 2013) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 23106903 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Topics

• Aged
• Cohort Studies
• Coronary Restenosis (diagnostic imaging, epidemiology)
• Diabetes Mellitus (diagnostic imaging, epidemiology)
• Female
• Humans
• Male
• Microvessels (diagnostic imaging, physiology)
• Middle Aged
• Neovascularization, Pathologic (diagnostic imaging)
• Radiography
• Retrospective Studies
• Tomography, Optical Coherence (methods)