Clinical Importance of the LDL-C/Apolipoprotein B Ratio for Neointimal Formation After Everolimus-Eluting Stent Implantations

Overview

Journal J Atheroscler Thromb

Date 2021 Mar 22

PMID 33746158

Citations 8

Authors

Naotaka Akutsu

Koichiro Hori

Saki Mizobuchi

Akihito Ogaku

Yutaka Koyama

Hidesato Fujito

Riku Arai

Yasunari Ebuchi

Suguru Migita

Tomoyuki Morikawa

Takehiro Tamaki

Keisuke Kojima

Nobuhiro Murata

Toshihiko Nishida

Daisuke Kitano

Daisuke Fukamachi

Yasuo Okumura

Affiliations

Soon will be listed here.

Abstract

Aims: Smaller low-density lipoprotein (LDL) particle size has been suggested to result in the development of endothelial dysfunction, atherosclerosis, and in-stent restenosis (ISR); however, little is known regarding the impact of the LDL particle size on the neointima formation leading to ISR after everolimus-eluting stent (EES) implantation.

Methods: In this study, we have included 100 patients to examine the relationship between an LDL-C/apolipoprotein B (Apo B) ≤ 1.2, reportedly representing the LDL particle size, and the neointimal characteristics using optical coherence tomography (OCT) and coronary angioscopy (CAS) during the follow-up coronary angiography (CAG) period (8.8±2.5 months) after EES implantation. We divided them into two groups: LDL-C/Apo B ≤ 1.2 group (low LDL-C/Apo B group, n=53) and LDL-C/Apo B ＞1.2 group (high LDL-C/Apo B group, n=47).

Results: The low LDL-C/Apo B group had a significantly larger neointimal volume (12.8±5.3 vs. 10.3±4.9 mm, p=0.021) and lower incidence of a neointimal homogeneous pattern (71 vs. 89 %), higher incidence of a neointimal heterogeneous pattern (25 vs. 9 %) (p=0.006) and higher prevalence of macrophage accumulation (9 vs. 2 %) (p=0.030) as assessed via OCT, and, as per the CAS findings, a higher prevalence of yellow grade ≥ 2 (grade 2; adjusted residual: 2.94, grade 3; adjusted residual: 2.00, p=0.017) than the high LDL-C/Apo B group.

Conclusions: A low LDL-C/Apo B ratio was found to be strongly associated with neointimal proliferation and neointimal instability evidenced chronically by OCT and CAS. An LDL-C/Apo B ≤ 1.2 will be of aid in terms of identifying high-risk patients after EES implantation.

Citing Articles

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