Aims: The purpose of this study was to investigate the impact of neoatherosclerosis on the prognosis after percutaneous coronary intervention (PCI) for in-stent restenosis (ISR).
Methods and Results: Between March 2009 and December 2017, 313 ISR lesions in patients undergoing an OCT guided PCI in five hospitals were retrospectively enrolled. Neoatherosclerosis was defined as a lipid neointima or calcified neointima. We examined the association between neoatherosclerosis and the clinical driven (CD-TLR) rates.
In 313 ISR lesions, 64 lesions (20.4%) had bare metal stents and 241 lesions (77.0%) had drug eluting stents (DES). Among them, 47.0% of lesions (147 lesions) had neoatherosclerosis. A multivariate logistic regression analysis demonstrated that eGFR (odds ratio (OR), 0.986; 95% confidence interval (CI), 0.974-0.998; P=0.023), the time from the PCI to the ISR (OR, 1.13; 95% CI, 1.06-1.22; P<0.001) and DES-ISR (OR, 2.48; 95% CI, 1.18-5.43; P=0.019 ) were independent predictors with neoatherosclerosis. A multivariate regression analysis demonstrated that neoatherosclerosis was an independent predictor of CD-TLR.
Conclusion: In the multicenter ISR registry, OCT imaging demonstrated that eGFR, the time from the PCI to the ISR and DES-ISR were independent predictors for neoatherosclerosis and neoatherosclerosis in ISR lesions had a worse impact on the CD-TLR.