Background:The relationship between the characteristics of tissue protrusion detected by using optical coherence tomography (OCT) and the findings of coronary angioscopy (CAS) immediately after stent implantation were evaluated.

Methods and Results:A total of 186 patients (192 stents) underwent OCT before and after stenting and were observed by using CAS immediately after stenting and at the chronic phase. Patients were assigned to irregular protrusion, smooth protrusion, and disrupted fibrous tissue protrusion groups according to OCT findings. Serum high-sensitivity C-reactive protein (hs-CRP) levels were measured before and after stent implantation. The grade of yellow color (YC) and neointimal coverage (NC), and incidence of thrombus in the stented segment were evaluated by using CAS. After stent implantation, maximum YC grade (smooth, 0.64±0.80; disrupted fibrous tissue, 0.50±0.77; irregular, 1.50±1.09; P<0.0001), a prevalence of Max-YC grade of 2 or 3 (smooth, 17%; disrupted fibrous tissue, 17%; irregular, 50%; P<0.0001) and thrombus (smooth, 15%; disrupted fibrous tissue, 10%; irregular, 69%; P=0.0005), and elevated hs-CRP levels (smooth, 0.22±0.89; disrupted fibrous tissue, −0.05±0.29; irregular, 0.75±1.41; P=0.023) were significantly higher in irregular protrusion than in the other 2 groups. In the chronic phase, maximum- and minimum-NC grade and heterogeneity index, and thrombus did not differ significantly among the 3 groups.

Conclusions:Irregular protrusion was associated with atherosclerotic yellow plaque, incidence of thrombus, and vascular inflammation. The angioscopic findings in the chronic phase may endorse the clinical efficacy of second- and third-drug eluting stents, regardless of the tissue protrusion type.

背景：评估了支架植入后立即使用光学相干断层扫描（OCT）检测到的组织突出特征与冠状动脉血管镜检查（CAS）结果之间的关系。

方法和结果：共有 186 名患者（192 个支架）在支架植入前后接受了 OCT，并在支架植入后即刻和慢性期使用 CAS 进行了观察。根据OCT结果将患者分为不规则突出组、平滑突出组和断裂纤维组织突出组。在支架植入前后测量血清高敏 C 反应蛋白 (hs-CRP) 水平。应用CAS评估黄色（YC）和新生内膜覆盖（NC）的等级，以及支架段内血栓的发生率。支架植入后，最大YC级（光滑，0.64±0.80；破坏的纤维组织，0.50±0.77；不规则，1.50±1.09；P<0.0001），Max-YC级的流行率为2或3（光滑，17%；破裂的纤维组织，17%；不规则的，50%；P<0.0001）和血栓（光滑的，15%；破裂的纤维组织，10%；不规则，69%；P=0.0005），不规则突出的 hs-CRP 水平升高（平滑，0.22±0.89；破坏的纤维组织，-0.05±0.29；不规则，0.75±1.41；P=0.023）在不规则突出中显着高于其他两组。在慢性期，3组之间最大和最小NC等级和异质性指数以及血栓没有显着差异。

结论：不规则突出与动脉粥样硬化黄色斑块、血栓发生和血管炎症有关。无论组织突出类型如何，慢性期的血管镜检查结果可能支持第二和第三药物洗脱支架的临床疗效。