P2687The predictors of neoatherosclerosis after drug-eluting stent implantation evaluated by optical coherence tomography

Objective: The aim of the current study is to elucidate the risk factors of neoatherosclerosis after coronary stent implantation by optical coherence tomography (OCT). Methods: In total, from June 2013 to June 2016, 40 patients who underwent coronary stent implantation and follow-up optical coherence tomography (OCT) in Peking University First Hospital were enrolled in the retrospective study. Based on the low dense lipoprotein-cholesterol (LDL-C) level at follow-up, the participants were divided into the on-target group (19 cases, LDL-C<1.8mmol/L) and the non-on-target group (21 cases LDL-C>1.8mmol/L). The neoatheroslerosis (NA) was defined as any of the OCT findings below: heterogeneous neointima, lipid-rich neointima, calcification,neovascularization, macrophage and cholesterol crystal in the neointima assessed by OCT. Results: There was no statistical difference of baseline clinical characteristics between two groups.On-target group LDL-C levels higher than the standard group [(2.42±0.79) mmol/L versus (1.3±0.35) mmol/L, P<0.001], statin dose of non-on-target group was higher than the standard group [(22.38±2.1) mg versus (15.26±2.3) mg P=0.032]. The OCT analysis showed that the incidence of NA in non-on-target group was significantly higher than the standard group [78.9% (15/19) versus 38.1% (8/21) P=0.009]; the occurrence of neointimal heterogeneity [78.9% (15/19) versus 38.1% (8/21) P=0.009],lipid plaque [73.7% (14/19) versus 38.1% (8/21) P=0.024], calcified plaque [26.3% (5/19) versus 4.8% (1/21) P=0.049] higher than the standard group, neovascularization, macrophage, cholesterol crystal proportion had no significant difference. The logistic analysis showed that the level of low density lipoprotein (P=0.009), statin dose (P=0.04), gender (male P=0.042) and serum creatinine (P=0.012) were associated with the present of NA. Additionally, LDL-C level and statin dosage were the independent factors. By ROC analysis, the cut-off value of LDL-C 1.78mmol/L at follow-up could significantly differentiate the patients with or without NA.