支架内新生动脉粥样硬化基础与临床研究进展

彭向, 田进伟

doi:10.12066/j.issn.1007-2861.2134

上海大学学报(自然科学版) >

2019 , Vol. 25 >Issue 3: 399 - 405

DOI: https://doi.org/10.12066/j.issn.1007-2861.2134

支架内新生动脉粥样硬化基础与临床研究进展

展开

^1. 哈尔滨医科大学附属第二医院心血管内科, 哈尔滨 150001
^2. 哈尔滨医科大学附属第二医院心肌缺血教育部重点实验室, 哈尔滨 150001

田进伟, 主任医师,授, 博士生导师, 国家万人计划青年拔尖人才,教育部长江学者奖励计划青年长江学者。
田进伟, 主任医师,授, 博士生导师, 哈尔滨医科大学第二附属医院心内科病区副主任.中华医学会心血管病学分会动脉粥样硬化与冠心病学组委员,中国医师协会心血管内科医师分会青年委员,中国医师协会临床精准医疗专业委员会青年委员,中国病理生理学会动脉粥样硬化专业委员会RCT 学组委员,中国心胸血管麻醉学会精准医疗分会青年委员,中国老年保健医学研究会高血压防治分会委员.毕业于哈尔滨医科大学(本硕博临床医学八年制) 曾留学美国哈佛大学医学院.主要从事冠心病、心力衰竭、高血压等疾病诊疗、科研及教学工作.多年来一直围绕动脉粥样硬化易损斑块开展研究, 在J Am Coll Cardiol, Heart及Circ Cardiovasc Imaging等专业期刊发表SCI论文49篇,参与编著多部心血管疾病诊断与治疗指南及专业书籍,主持国家自然科学基金等心血管疾病相关研究项目11项.获得国家万人计划青年拔尖人才、教育部长江学者奖励计划青年长江学者与黑龙江科技英才等荣誉.

收稿日期: 2019-04-08

网络出版日期: 2019-06-24

基金资助

国家自然科学基金面上资助项目(81571749);科技部重点专项资助项目(2016YFC1301302)

收起

Basic and clinic advances of in-stent neoatherosclerosis

Expand

^1. Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, China
^2. The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, China

Received date: 2019-04-08

Online published: 2019-06-24

Fold

摘要

支架内新生动脉粥样硬化,(in-stent neoatherosclerosis, ISNA),是导致晚期支架失效的主要原因之一, 在支架血栓形成,(stent thrombosis, ST),和支架内再狭窄,(in-stent restenosis, ISR),中发挥重要作用.但目前,ISNA,具体机制未清且尚缺乏有效的治疗策略,探索,ISNA,发生发展机制以及研究,ISNA,的诊治方法对于改善支架置入后患者预后具有重大的临床意义.系统综述了支架内新生动脉粥样硬化基础与临床研究进展.

关键词： 新生动脉粥样硬化; 支架血栓形成; 支架内再狭窄; 药物洗脱支架; 光学相干断层成像

本文引用格式

彭向, 田进伟 . 支架内新生动脉粥样硬化基础与临床研究进展[J]. 上海大学学报(自然科学版), 2019 , 25(3) : 399 -405 . DOI: 10.12066/j.issn.1007-2861.2134

Abstract

In-stent neoatherosclerosis (ISNA) has been identified as a major contributing factor to late stent failure resulting from stent thrombosis (ST) and in-stent restenosis (ISR). However, the accurate mechanism of ISNA remains unknown to this day and the absence of effective therapeutic strategy remains an essential issue to be solved. Hence, future studies should focus on the mechanism of ISNA progression and the treatment of ISNA, which are of great clinical significance for improving the prognosis of patients following stent implantation. In this paper, the basic and clinic advances of ISNA have been addressed.

Key words： in-stent neoatherosclerosis; stent thrombosis; in-stent restenosis; drug-eluting stents; optical coherence tomography

参考文献

[1]	Zhao D, Liu J, Wang M , et al. Epidemiology of cardiovascular disease in China: current features and implications[J]. Nature Reviews Cardiology, 2019,16:203-212.
[2]	Park S J, Kang S J, Virmani R , et al. In-stent neoatherosclerosis: a final common pathway of late stent failure[J]. Journal of the American College of Cardiology, 2012,59:2051-2057.
[3]	Adriaenssens T, Joner M, Godschalk T C , et al. Optical coherence tomography findings in patients with coronary stent thrombosis: a report of the PRESTIGE consortium (prevention of late stent thrombosis by an interdisciplinary global european effort)[J]. Circulation, 2017,136:1007-1021.
[4]	Kang S J, Mintz G S, Park D W , et al. Tissue characterization of in-stent neointima using intravascular ultrasound radiofrequency data analysis[J]. The American Journal of Cardiology, 2010,106:1561-1565.
[5]	Nakazawa G, Otsuka F, Nakano M , et al. The pathology of neoatherosclerosis in human coronary implants bare-metal and drug-eluting stents[J]. Journal of the American College of Cardiology, 2011,57:1314-1322.
[6]	Higo T, Ueda Y, Oyabu J , et al. Atherosclerotic and thrombogenic neointima formed over sirolimus drug-eluting stent: an angioscopic study[J]. JACC Cardiovascular Imaging, 2009,2(5):616-624.
[7]	Otsuka F, Byrne R A, Yahagi K , et al. Neoatherosclerosis: overview of histopathologic findings and implications for intravascular imaging assessment[J]. European Heart Journal, 2015,36:2147-2159.
[8]	Yahagi K, Kolodgie F D, Otsuka F , et al. Pathophysiology of native coronary, vein graft, and in-stent atherosclerosis[J]. Nature Reviews Cardiology, 2016,13:79-98.
[9]	Lee C W, Kang S J, Park D W , et al. Intravascular ultrasound findings in patients with very late stent thrombosis after either drug-eluting or bare-metal stent implantation[J]. Journal of the American College of Cardiology, 2010,55:1936-1942.
[10]	Finn A V, Otsuka F . Neoatherosclerosis: a culprit in very late stent thrombosis[J]. Circulation Cardiovascular Interventions, 2012,5:6-9.
[11]	Warboys C M, De Luca A, Amini N , et al. Disturbed flow promotes endothelial senescence via a p53-dependent pathway[J]. Arteriosclerosis, Thrombosis, and Vascular Biology, 2014,34:985-995.
[12]	Kimura T, Yokoi H, Nakagawa Y , et al. Three-year follow-up after implantation of metallic coronary-artery stents[J]. The New England Journal of Medicine, 1996,334:561-566.
[13]	Chen M S, John J M, Chew D P , et al. Bare metal stent restenosis is not a benign clinical entity[J]. American Heart Journal, 2006,151:1260-1264.
[14]	Kimura T, Abe K, Shizuta S , et al. Long-term clinical and angiographic follow-up after coronary stent placement in native coronary arteries[J]. Circulation, 2002,105:2986-2991.
[15]	Yokoyama S, Takano M, Yamamoto M , et al. Extended follow-up by serial angioscopic observation for bare-metal stents in native coronary arteries: from healing response to atherosclerotic transformation of neointima[J]. Circulation Cardiovascular Interventions, 2009,2:205-212.
[16]	Natsuaki M, Morimoto T, Furukawa Y , et al. Late adverse events after implantation of sirolimus-eluting stent and bare-metal stent: long-term (5-7 years) follow-up of the Coronary Revascularization Demonstrating Outcome study-Kyoto registry Cohort-2[J]. Circulation Cardiovascular Interventions, 2014,7(2):168-179.
[17]	Grube E, Dawkins K, Guagliumi G , et al. TAXUS Ⅵfinal 5-year results: a multicentre, randomised trial comparing polymer-based moderate-release paclitaxel-eluting stent with a bare metal stent for treatment of long, complex coronary artery lesions[J]. EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2009,4:572-577.
[18]	Kang S J, Park D W, Mintz G S , et al. Long-term vascular changes after drug-eluting stent implantation assessed by serial volumetric intravascular ultrasound analysis[J]. The American Journal of Cardiology, 2010,105:1402-1408.
[19]	Nakazawa G, Vorpahl M, Finn A V , et al. One step forward and two steps back with drug-eluting-stents: from preventing restenosis to causing late thrombosis and nouveau atherosclerosis[J]. JACC Cardiovascular Imaging, 2009,2:625-628.
[20]	Romero M E, Yahagi K, Kolodgie F D , et al. Neoatherosclerosis from a pathologist's point of view[J]. Arteriosclerosis, Thrombosis, and Vascular Biology, 2015,35:e43-e49.
[21]	Otsuka F, Vorpahl M, Nakano M , et al. Pathology of second-generation everolimus-eluting stents versus first-generation sirolimus- and paclitaxel-eluting stents in humans[J]. Circulation, 2014,129:211-223.
[22]	Yonetsu T, Kato K, Kim S J , et al. Predictors for neoatherosclerosis: a retrospective observational study from the optical coherence tomography registry[J]. Circulation Cardiovascular Imaging, 2012,5:660-666.
[23]	Gomez-Lara J, Brugaletta S, Jacobi F , et al. Five-year optical coherence tomography in patients with ST-segment-elevation myocardial infarction treated with bare-metal versus everolimus-eluting stents[J]. Circulation Cardiovascular Interventions, 2016,9(10):e003670.
[24]	Taniwaki M, Windecker S, Zaugg S , et al. The association between in-stent neoatherosclerosis and native coronary artery disease progression: a long-term angiographic and optical coherence tomography cohort study[J]. European Heart Journal, 2015,36:2167-2176.
[25]	Habara M, Terashima M, Nasu K , et al. Difference of tissue characteristics between early and very late restenosis lesions after bare-metal stent implantation: an optical coherence tomography study[J]. Circulation Cardiovascular Interventions, 2011,4:232-238.
[26]	Takano M, Yamamoto M, Inami S , et al. Appearance of lipid-laden intima and neovascularization after implantation of bare-metal stents extended late-phase observation by intracoronary optical coherence tomography[J]. Journal of the American College of Cardiology, 2009,55:26-32.
[27]	Kang S J, Mintz G S, Akasaka T , et al. Optical coherence tomographic analysis of in-stent neoatherosclerosis after drug-eluting stent implantation[J]. Circulation, 2011,123:2954-2963.
[28]	Raber L, Serruys P W . Late vascular response following drug-eluting stent implantation[J]. JACC Cardiovascular Interventions, 2011,4:1075-1078.
[29]	Joner M, Nakazawa G, Finn A V , et al. Endothelial cell recovery between comparator polymer-based drug-eluting stents[J]. Journal of the American College of Cardiology, 2008,52:333-342.
[30]	Torii R, Stettler R, Raber L , et al. Implications of the local hemodynamic forces on the formation and destabilization of neoatherosclerotic lesions[J]. International Journal of Cardiology, 2018,272:7-12.

Options

文章导航

模态框（Modal）标题

摘要

本文引用格式

Abstract

参考文献