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BMC Cardiovascular Disorders
Published in: BMC Cardiovascular Disorders 1/2017

Open Access 01-12-2017 | Research article

Effects of angiotensin receptor blockers on neointimal characteristics in angina patients requiring stent implantation: optical coherence tomography analysis

Authors: Jae Young Cho, Soon Jun Hong, Do-Sun Lim

Published in: BMC Cardiovascular Disorders | Issue 1/2017

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Abstract

Background

Angiotensin receptor blockers (ARBs) are known for its anti-inflammatory and anti-proliferative effects. The aim of the study was to evaluate long-term effects of ARBs on morphologic characteristics of stent restenosis in patients with coronary artery disease requiring stent implantation by optical coherence tomography (OCT).

Methods

Patients with coronary artery disease having history of drug-eluting stent implantation (n = 407) were analyzed on the basis of ARB therapy as the ARB group (n = 162) and the non-ARB group (n = 245). Neointimal characterizations were performed at lesions with diameter stenosis >30% with OCT in each group. Major adverse cardiovascular events (MACEs), lumen area, stent area, neointimal area, neointimal thickness, nonapposed struts, uncovered struts, and intraluminal mass between two groups were also observed.

Results

More patients in the ARB group revealed homogeneous and layered neointimal pattern (44.9% vs. 35.6%, P < 0.001, and 16.8% vs. 10.6%, P < 0.001, respectively), and whereas patients in the non-ARB group revealed heterogeneous neointimal pattern (1.1% vs. 7.6%, P < 0.001). Mean neointimal area (1.09 ± 1.00 mm2 vs. 1.38 ± 1.24 mm2) and mean neointimal thickness (140.6 ± 112.0 μm vs. 189.6 ± 423.1 μm) with OCT were smaller in the ARB group when compared to the non-ARB group. Percentage of covered stents was significantly higher in the ARB group when compared to the Non-ARB group (97.3% vs. 92.6%, P = 0.015). Other factors such as follow-up % diameter stenosis, late lumen loss, binary restenosis, MACEs, various neointimal characteristics analyzed by image analyzing software did not show significant differences.

Conclusion

The use of ARBs after drug-eluting stent implantation demonstrated difference in neointimal characteristics, less amount of neointimal area and fewer number of uncovered stent struts during the follow-up OCT, indicating the anti-proliferative and anti-inflammatory effects of ARBs.
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Metadata
Title
Effects of angiotensin receptor blockers on neointimal characteristics in angina patients requiring stent implantation: optical coherence tomography analysis
Authors
Jae Young Cho
Soon Jun Hong
Do-Sun Lim
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2017
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-017-0709-9

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