Renal dysfunction and atherosclerosis of the neointima following bare metal stent implantation

Shinji Hayano, Hideki Ishii, Satoshi Ichimiya, Masaaki Kanashiro, Junji Watanabe, Susumu Suzuki, Daiji Yoshikawa, Kengo Maeda, Tatsuaki Matsubara, Toyoaki Murohara

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background: Recently, neoatherosclerosis within the neointima after bare metal stent (BMS) implantation, which could cause late restenosis and very late stent thrombosis, has been a cause of concern. Renal dysfunction has been related to late cardiovascular events after coronary intervention. The present study was conducted focusing on the relationship between renal dysfunction and neointimal tissue characteristics with BMS restenosis using integrated backscatter intravascular ultrasound (IB-IVUS). Methods: We prospectively performed IB-IVUS in 80 consecutive patients requiring target lesion revascularization after BMS implantation; the patients were divided into two groups according to the estimated glomerular filtration [eGFR: ≥60 (n = 49) and <60 ml/min/1.73 m2 (n = 31)]. Results: Patients with eGFR <60 ml/min/1.73 m2 had a significantly higher percentage of lipid tissue volume within the neointima and a lower percentage of fibrous tissue volume than those with eGFR ≥60 ml/min/1.73 m2 (23.2 ± 9.4 vs. 18.0 ± 7.0%, p = 0.005, and 75.3 ± 9.3 vs. 80.4 ± 7.0%, p = 0.007, respectively). Using logistic regression analysis, eGFR <60 ml/min/1.73 m2 and duration from stent implantation ≥48 months were independent predictors of increased lipid tissue volume within the neointima (odds ratio, 3.93; 95% confidence interval, 1.15-13.46, p = 0.03, and odds ratio, 7.56; 95% confidence interval, 2.02-28.30, p = 0.003, respectively). Conclusions: Lower eGFR levels were associated with greater lipid tissue volume within the neointima after BMS deployment, suggesting the development of atherosclerosis. Renal dysfunction may affect neointimal tissue characteristics and thus leading to an increased risk of late stent failure.

Original languageEnglish
Pages (from-to)58-65
Number of pages8
JournalAmerican Journal of Nephrology
Volume38
Issue number1
DOIs
Publication statusPublished - 12-04-2013
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Nephrology

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