Advertisement

Impact of Cigarette Smoking and Smoking Cessation on Stent Changes as Determined by Optical Coherence Tomography After Sirolimus Stent Implantation

  • Xingtao Huang
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
    Search for articles by this author
  • Xuedong Wang
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
    Search for articles by this author
  • Yongpeng Zou
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
    Search for articles by this author
  • Shuyuan Chen
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
    Search for articles by this author
  • Ruoxi Zhang
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
    Search for articles by this author
  • Lulu Li
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
    Search for articles by this author
  • Bo Yu
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
    Search for articles by this author
  • Jingbo Hou
    Correspondence
    Corresponding author: Tel: +86 0451 86605180; fax: +86 0451 86605180.
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
    Search for articles by this author
      There is debate regarding whether smoking results in microstructural changes after stenting. The aim of this study was to evaluate the microstructural changes after stenting in patients with different smoking statuses. We retrospectively identified 220 sirolimus-eluting stents in 179 patients who underwent follow-up optical coherence tomography examination 12 months after sirolimus stenting. Subjects were classified as current smokers (CS, n = 31), smoking cessation ≤1 year (n = 36), smoking cessation >1 year (SC > 1Y, n = 27), and never smokers (NS, n = 85). The neointimal hyperplasia (NIH) area was larger in CS than in NS (1.04 ± 0.72 mm2 vs 0.96 ± 0.68 mm2; p = 0.04). The incidence of lipid-laden neointima was lower in SC > 1Y patients (1.6%) than in all other patients (NS: 3.9%, p = 0.002; CS: 3.0%, p = 0.073; SC1Y: 5.0%, p <0.001). Smoking cessation level was negatively correlated with NIH (B = −0.154; 95% confidential interval −0.187, −0.121; p <0.001) and independently associated with the presence of homogeneous neointima (odds ratio: 1.414; 95% confidential interval 1.145, 1.745; p = 0.001). The incidence of malapposed struts was higher in CS than in NS (3.2% vs 1.6%; p = 0.004). However, smoking cessation patients showed a decreased trend in the incidence of malapposed struts (p = 0.0003). In conclusion, continued smoking increases NIH and the incidence of malapposed struts. However, smoking cessation slows down NIH progression and decreases the incidence of malapposed struts. Smoking cessation promotes vascular healing after stenting.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Anderson K.M.
        • Wilson P.W.
        • Odell P.M.
        • Kannel W.B.
        An updated coronary risk profile. A statement for health professionals.
        Circulation. 1991; 83: 356-362
        • Petrik P.V.
        • Gelabert H.A.
        • Moore W.S.
        • Quinones-Baldrich W.
        • Law M.M.
        Cigarette smoking accelerates carotid artery intimal hyperplasia in a dose-dependent manner.
        Stroke. 1995; 26: 1409-1414
        • Gao L.
        • Park S.J.
        • Jang Y.
        • Lee S.
        • Tian J.
        • Minami Y.
        • Jia H.
        • Ong D.
        • Soeda T.
        • Vergallo R.
        • Lee H.
        • Yu B.
        • Uemura S.
        • Jang I.K.
        Optical coherence tomographic evaluation of the effect of cigarette smoking on vascular healing after sirolimus-eluting stent implantation.
        Am J Cardiol. 2015; 115: 751-757
        • Bowman T.S.
        • Gaziano J.M.
        • Buring J.E.
        • Sesso H.D.
        A prospective study of cigarette smoking and risk of incident hypertension in women.
        J Am Coll Cardiol. 2007; 50: 2085-2092
        • Patrick D.L.
        • Cheadle A.
        • Thompson D.C.
        • Diehr P.
        • Koepsell T.
        • Kinne S.
        The validity of self-reported smoking: a review and meta-analysis.
        Am J Public Health. 1994; 84: 1086-1093
        • Vartiainen E.
        • Seppala T.
        • Lillsunde P.
        • Puska P.
        Validation of self reported smoking by serum cotinine measurement in acommunity-based study.
        J Epidemiol Community Health. 2002; 56: 167-170
        • Rebagliato M.
        Validation of self reported smoking.
        J Epidemiol Community Health. 2002; 56: 163-164
        • Raffel O.C.
        • Akasaka T.
        • Jang I.K.
        Cardiac optical coherence tomography.
        Heart. 2008; 94: 1200-1210
        • Bezerra H.G.
        • Costa M.A.
        • Guagliumi G.
        • Rollins A.M.
        • Simon D.I.
        Intracoronary optical coherence tomography: a comprehensive review clinical and research applications.
        JACC Cardiovasc Interv. 2009; 2: 1035-1046
        • Ong D.S.
        • Jang I.K.
        Causes, assessment, and treatment of stent thrombosis—intravascular imaging insights.
        Nat Rev Cardiol. 2015; 12: 325-336
        • Di Vito L.
        • Yoon J.H.
        • Kato K.
        • Yonetsu T.
        • Vergallo R.
        • Costa M.
        • Bezerra H.G.
        • Arbustini E.
        • Narula J.
        • Crea F.
        • Prati F.
        • Jang I.K.
        • COICO group (Consortium of Investigators for Coronary OCT)
        Comprehensive overview of definitions for optical coherence tomography-based plaque and stent analyses.
        Coron Artery Dis. 2014; 25: 172-185
        • Han Z.
        • Feng L.
        • Du H.
        • Sun Z.
        • Hu S.
        • Dai J.
        • Sun M.
        • Xing L.
        • Hou J.
        • Zhang S.
        • Yu B.
        Impact of age on stent strut coverage and neointimal remodeling as assessed by optical coherence tomography.
        Medicine (Baltimore). 2015; 94: e2246
        • Ishigami K.
        • Uemura S.
        • Morikawa Y.
        • Soeda T.
        • Okayama S.
        • Nishida T.
        • Takemoto Y.
        • Onoue K.
        • Somekawa S.
        • Takeda Y.
        • Kawata H.
        • Horii M.
        • Saito Y.
        Long-term follow-up of neointimal coverage of sirolimus-eluting stents—evaluation with optical coherence tomography.
        Circ J. 2009; 73: 2300-2307
        • Villablanca A.C.
        Nicotine stimulates DNA synthesis and proliferation in vascular endothelial cells in vitro.
        J Appl Physiol (1985). 1998; 84: 2089-2098
        • Hamasaki H.
        • Sato J.
        • Masuda H.
        • Tamaoki S.
        • Isotani E.
        • Obayashi S.
        • Udagawa T.
        • Azuma H.
        Effect of nicotine on the intimal hyperplasia after endothelial removal of the rabbit carotid artery.
        Gen Pharmacol. 1997; 28: 653-659
        • Welt F.G.
        • Rogers C.
        Inflammation and restenosis in the stent era.
        Arterioscler Thromb Vasc Biol. 2002; 22: 1769-1776
        • Kornowski R.
        • Hong M.K.
        • Tio F.O.
        • Bramwell O.
        • Wu H.
        • Leon M.B.
        In-stent restenosis: contributions of inflammatory responses and arterial injury to neointimal hyperplasia.
        J Am Coll Cardiol. 1998; 31: 224-230
        • Lee J.
        • Taneja V.
        • Vassallo R.
        Cigarette smoking and inflammation: cellular and molecular mechanisms.
        J Dent Res. 2012; 91: 142-149
        • Bakhru A.
        • Erlinger T.P.
        Smoking cessation and cardiovascular disease risk factors: results from the Third National Health and Nutrition Examination Survey.
        PLoS Med. 2005; 2: e160
        • Hassan A.K.
        • Bergheanu S.C.
        • Stijnen T.
        • van der Hoeven B.L.
        • Snoep J.D.
        • Plevier J.W.
        • Schalij M.J.
        • Wouter Jukema J.
        Late stent malapposition risk is higher after drug-eluting stent compared with bare-metal stent implantation and associates with late stent thrombosis.
        Eur Heart J. 2010; 31: 1172-1180
        • Cook S.
        • Wenaweser P.
        • Togni M.
        • Billinger M.
        • Morger C.
        • Seiler C.
        • Vogel R.
        • Hess O.
        • Meier B.
        • Windecker S.
        Incomplete stent apposition and very late stent thrombosis after drug-eluting stent implantation.
        Circulation. 2007; 115: 2426-2434
        • Bouki K.P.
        • Chatzopoulos D.N.
        • Katsafados M.G.
        • Elaiopoulos D.A.
        • Psychari S.N.
        • Apostolou T.S.
        Late acquired stent malapposition detected by optical coherence tomography examination.
        Int J Cardiol. 2009; 137: e77-e78
        • Wang S.
        • Zhang C.
        • Zhang M.
        • Liang B.
        • Zhu H.
        • Lee J.
        • Viollet B.
        • Xia L.
        • Zhang Y.
        • Zou M.H.
        Activation of AMP-activated protein kinase alpha2 by nicotine instigates formation of abdominal aortic aneurysms in mice in vivo.
        Nat Med. 2012; 18: 902-910
        • Kugo H.
        • Zaima N.
        • Tanaka H.
        • Urano T.
        • Unno N.
        • Moriyama T.
        The effects of nicotine administration on the pathophysiology of rat aortic wall.
        Biotech Histochem. 2017; 92: 141-148
        • Vergallo R.
        • Yonetsu T.
        • Uemura S.
        • Park S.J.
        • Lee S.
        • Kato K.
        • Jia H.
        • Abtahian F.
        • Tian J.
        • Hu S.
        • Lee H.
        • McNulty I.
        • Prasad A.
        • Yu B.
        • Zhang S.
        • Porto I.
        • Biasucci L.M.
        • Crea F.
        • Jang I.K.
        Correlation between degree of neointimal hyperplasia and incidence and characteristics of neoatherosclerosis as assessed by optical coherence tomography.
        Am J Cardiol. 2013; 112: 1315-1321
        • Kim J.S.
        • Lee J.H.
        • Shin D.H.
        • Kim B.K.
        • Ko Y.G.
        • Choi D.
        • Jang Y.
        • Hong M.K.
        Long-term outcomes of neointimal hyperplasia without neoatherosclerosis after drug-eluting stent implantation.
        JACC Cardiovasc Imaging. 2014; 7: 788-795