Optical Coherence Tomographic Evaluation of the Effect of Cigarette Smoking on Vascular Healing After Sirolimus-Eluting Stent Implantation

• Published in: The American journal of cardiology 2015-03, Vol.115 (6), p.751-757
• Main Authors: Gao, Lei, MD, PhD, Park, Seung-Jung, MD, PhD, Jang, Yangsoo, MD, PhD, Lee, Stephen, MD, Tian, Jinwei, MD, PhD, Minami, Yoshiyasu, MD, PhD, Jia, Haibo, MD, PhD, Ong, Daniel, MD, Soeda, Tsunenari, MD, PhD, Vergallo, Rocco, MD, Lee, Hang, PhD, Yu, Bo, MD, PhD, Uemura, Shiro, MD, PhD, Jang, Ik-Kyung, MD, PhD
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Adult; Angioplasty; Anti-Bacterial Agents - therapeutic use; Cardiovascular; Coronary Artery Disease - diagnosis; Coronary vessels; Coronary Vessels - drug effects; Coronary Vessels - pathology; Diabetes; Drug-Eluting Stents; Female; Follow-Up Studies; Hospitals, General; Humans; Hypertension; Immunosuppressive Agents - therapeutic use; Logistics; Male; Medical imaging; Medical Records Systems, Computerized; Middle Aged; Neointima - pathology; Patients; Predictive Value of Tests; Prosthesis Design; Risk Factors; Sensitivity and Specificity; Sirolimus - therapeutic use; Smoking; Smoking - adverse effects; Software; Stents; Time Factors; Tomography; Tomography, Optical Coherence - methods; Treatment Outcome; Wound Healing
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2014.12.038

Cigarette smoking is known to be deleterious to patients with coronary artery disease; however, the effect of smoking on vascular responses after coronary drug-eluting stent implantation is unknown. We sought to examine vascular response after sirolimus-eluting stent implantation in patients with ongoing smoking using optical coherence tomography, compared with former smokers and nonsmokers. We identified 181 sirolimus-eluting stents in 140 subjects who underwent follow-up optical coherence tomography imaging. Subjects were divided into 3 groups: current smokers (n = 28), former smokers (n = 35), and nonsmokers (n = 77). Stent strut coverage, neointimal characteristics, and strut malapposition were evaluated. The incidence of uncovered stent struts was significantly higher in nonsmokers compared with current smokers (13.3 ± 13.3% vs 6.7 ± 8.3%; p = 0.001). On qualitative evaluation of neointimal morphology, the prevalence of heterogeneous neointima was higher in current smokers (71.9%) than in former smokers (36.0%) or nonsmokers (10.1%) (p = 0.004 and p