Impact of local endothelial shear stress on neointima and plaque following stent implantation in patients with ST-elevation myocardial infarction: A subgroup-analysis of the COMFORTABLE AMI-IBIS 4 trial.

Bourantas, Christos V; Räber, Lorenz; Zaugg, Serge; Sakellarios, Antonis; Taniwaki, Masanori; Heg, Dik; Moschovitis, Aris; Radu, Maria; Papafaklis, Michail I; Kalatzis, Fanis; Naka, Katerina K; Fotiadis, Dimitrios I; Michalis, Lampros K; Serruys, Patrick W; Garcia Garcia, Hector M; Windecker, Stephan (2015). Impact of local endothelial shear stress on neointima and plaque following stent implantation in patients with ST-elevation myocardial infarction: A subgroup-analysis of the COMFORTABLE AMI-IBIS 4 trial. International journal of cardiology, 186, pp. 178-185. Elsevier 10.1016/j.ijcard.2015.03.160

[img] Text
Bourantas IntJCardiol 2015.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (1MB) | Request a copy

BACKGROUND Numerous studies have demonstrated an association between endothelial shear stress (ESS) and neointimal formation after stent implantation. However, the role of ESS on the composition of neointima and underlying plaque remains unclear. METHODS Patients recruited in the Comfortable AMI-IBIS 4 study implanted with bare metal stents (BMS) or biolimus eluting stents (BES) that had biplane coronary angiography at 13month follow-up were included in the analysis. The intravascular ultrasound virtual-histology (IVUS-VH) and the angiographic data were used to reconstruct the luminal surface, and the stent in the stented segments. Blood flow simulation was performed in the stent surface, which was assumed to represent the luminal surface at baseline, to assess the association between ESS and neointima thickness. The predominant ESS was estimated in 3-mm segments and was correlated with the amount of neointima, neointimal tissue composition, and with the changes in the underlying plaque burden and composition. RESULTS Forty three patients (18 implanted with BMS and 25 with BES) were studied. In both stent groups negative correlations were noted between ESS and neointima thickness in BMS (P<0.001) and BES (P=0.002). In BMS there was a negative correlation between predominant ESS and the percentage of the neointimal necrotic core component (P=0.015). In BES group, the limited neointima formation did not allow evaluation of the effect of ESS on its tissue characteristics. ESS did not affect vessel wall remodeling and the plaque burden and composition behind BMS (P>0.10) and BES (P>0.45). CONCLUSIONS ESS determines neointimal formation in both BMS and BES and affects the composition of the neointima in BMS. Conversely, ESS does not impact the plaque behind struts irrespective of stent type throughout 13months of follow-up.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Räber, Lorenz; Zaugg, Serge; Heg, Dierik Hans; Moschovitis, Aris and Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0167-5273

Publisher:

Elsevier

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

17 Apr 2015 10:51

Last Modified:

08 Sep 2017 18:18

Publisher DOI:

10.1016/j.ijcard.2015.03.160

PubMed ID:

25828109

Uncontrolled Keywords:

Endothelial shear stress; Neo-atherosclerosis; Neointimal formation

BORIS DOI:

10.7892/boris.67662

URI:

https://boris.unibe.ch/id/eprint/67662

Actions (login required)

Edit item Edit item
Provide Feedback