Positive geometric remodelling of native denovo coronary lesions predicts clinical restenosis after stent implantation

J. M. Ahmed, G. Dangas, G. S. Mintz, R. Mehran, M. K. Hong, A. J. Lansky, J. R. Laird, M. Peterson, L. F. Satler, K. M. Kent, Martin B. Leon

Research output: Contribution to journalArticle

Abstract

Coronary artery stenting eliminates late lumen loss due to arterial constriction, and instent restenosis is due to neointimal hyperplasia. We used pre-interventional intravascular ultrasound (IVUS) to study the impact of baseline arterial remodelling (REM) at the target lesion site on long-term outcome after stenting in 813 denovo coronary lesions in 701 patients. REM was determined by comparing the lesion external elastic membrane area (EEM) to the mean reference (Ref) EEM. REM was defined as negative (-REM: lesion/Ref EEM<1.0, n=461) or positive (+REM: lesion/Ref EEM ≥1.0, n=352). Patients were followed for a mean of 12 months to determine target lesion revascularisation (TLR). -REM +REM p Diabetes (%) 24.0 29.9 0.08 Ref luminal area (%) 8.4±0.1 8.1±0.2 0.1 Final stent area (%) 7.7±0.1 7.6±0.1 0.6 Final luminalarea (%) 7.6±0.1 7.5±0.1 0.3 TLR (%) 9.5 11.3 0.03 Conclusion: Native denovo lesions with -REM, as defined by pre-intervention IVUS, have a lower TLR after stenting compared to +REM. The probability of TLR after stenting increases with increasing +REM. Documentation of baseline negative REM may indicate that the lesion is less prone to develop exaggerted neointimal hyperplasia.

Original languageEnglish (US)
JournalHeart
Volume81
Issue numberSUPPL. 1
StatePublished - May 1999
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Ahmed, J. M., Dangas, G., Mintz, G. S., Mehran, R., Hong, M. K., Lansky, A. J., Laird, J. R., Peterson, M., Satler, L. F., Kent, K. M., & Leon, M. B. (1999). Positive geometric remodelling of native denovo coronary lesions predicts clinical restenosis after stent implantation. Heart, 81(SUPPL. 1).