P1695Impaired endothelial function is associated with neointimal abnormalities after drug-eluting stents deployment assessed by optical coherence tomography in patients with ischemic heart disease

Introduction: Neointimal abnormalities such as uncovered strut, late-acquired incomplete stent apposition (ISA), and evagination assessed by optical coherence tomography (OCT) might clarify the pathophysiology of stent thrombosis. Relationship between endothelial dysfunction and neointimal abnormalities in patients with ischemic heart disease (IHD) is not verified. Purpose: The aim of this study was to assess the relationship between initial endothelial function and neointimal characteristics after 2nd generation drug-eluting stent (DES) deployment in IHD patients. Methods: A total of 56 patients implanted 2nd generation DES were enrolled (70±11 yrs; 44 men). Sixty two lesions (12636 struts) were analyzed by OCT at 7-months follow-up and endothelial function was assessed by reactive hyperemia index (RHI) using Endo-PAT 2000. Patients were divided into 2 groups; endothelial dysfunction group (RHI<1.67) and normal endothelial function group (RHI≥1.67). Results: The frequency of uncovered strut, evagination, and/or late-acquired ISA was higher and neo-intimal thickness was thinner in endothelial dysfunction group than in normal endothelial function group (24.1% vs 15.4%, p<0.001; 61.2±58.2 μm vs 103.9±98.5 μm, p<0.001, respectively). Furthermore, neointimal thickness was associated with neointimal abnormalities and RHI, with 80.9% of neointimal abnormalities and 1.47±0.45 of RHI in lowest neointimal thickness quartile, respectively. Multivariate logistic analysis revealed the presence of RHI<1.67, acute coronary syndrome, and hyperuricemia were independent predictors for the presence of neointimal abnormalities.