Impact of Preprocedural High-Sensitivity C-Reactive Protein Levels on Uncovered Stent Struts: An Optical Coherence Tomography Study After Drug-Eluting Stent Implantation

Authors

  • Byeong-Keuk Kim MD,

    1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
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  • Jung-Sun Kim MD,

    1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
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  • Changmyung Oh MD,

    1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
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  • Young-Guk Ko MD,

    1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
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  • Donghoon Choi MD,

    1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
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  • Yangsoo Jang MD,

    1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
    2. Severance Biomedical Science Institute (Jang, Hong), Yonsei University College of Medicine, Seoul, Korea
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  • Myeong-Ki Hong MD

    Corresponding author
    1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
    2. Severance Biomedical Science Institute (Jang, Hong), Yonsei University College of Medicine, Seoul, Korea
    • Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea
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Abstract

Background

There are no sufficient data to evaluate the relationship between high-sensitivity C-reactive protein (hs-CRP) and uncovered stent struts on optical coherence tomography (OCT) after drug-eluting stent (DES) implantation.

Hypothesis

We evaluated the relationship between the preprocedural level of hs-CRP and incomplete neointimal coverage of DES struts on OCT.

Methods

This study was conducted using 124 eligible patients (132 lesions) treated with sirolimus-eluting stents (SES) or zotarolimus-eluting stents (ZES). The subjects were divided into 2 groups based on the preprocedural hs-CRP level: high-CRP (≥3 mg/L; 58 lesions) and normal-CRP (<3 mg/L, 74 lesions) groups. The percentage of uncovered struts, calculated as the ratio of uncovered struts to total struts in all OCT cross-sections, was compared between the 2 groups according to initial clinical presentation (stable angina [SA] vs acute coronary syndrome) and the type of implanted DES (SES vs ZES).

Results

There was no significant correlation between hs-CRP and the percentage of uncovered struts on OCT in all enrolled lesions. In the SA subgroup, the percentage of uncovered struts was significantly higher in the high-CRP group than in the normal-CRP group (8.1 ± 11.6% vs 3.8 ± 7.9%, P = 0.018). There was significant correlation between hs-CRP level and the percentage of uncovered struts in SA patients with SES (r = 0.280, P = 0.039), but not ZES (r = − 0.063, P = 0.729).

Conclusions

Preprocedural hs-CRP level could affect incomplete neointimal coverage of struts after DES implantation depending on the initial clinical presentation and the type of implanted DES. Copyright © 2011 Wiley Periodicals, Inc.

This study was partly supported by grants from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (No. A085012 and A102064), the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (No. A085136), and the Cardiovascular Research Center, Seoul, Korea. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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