{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T17:50:56Z","timestamp":1791654656651,"version":"4.3.4"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Re-endothelialization is delayed after drug-eluting stent (DES) implantation. In this setting, neointima is more prone to become lipid laden and develop neoatherosclerosis (NA), potentially increasing plaque vulnerability.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Optical coherence tomography and near-infrared spectroscopy with intravascular ultrasound were used to characterize NA in 65 (51 DES and 14 bare-metal stents) consecutive symptomatic patients with in-stent restenosis. Median duration poststent implantation was 33 months. Optical coherence tomography\u2013verified NA was observed in 40 stents with in-stent restenosis (62%), was more prevalent in DES than bare-metal stents (68% versus 36%;\n              <jats:italic>P<\/jats:italic>\n              =0.02), and demonstrated significantly higher prevalence of thin-cap neoatheroma (47% versus 7%;\n              <jats:italic>P<\/jats:italic>\n              =0.01) in DES. Near-infrared spectroscopy assessment demonstrated that the total lipid core burden index (34 [interquartile range, 12\u201392] versus 9 [interquartile range, 0\u201332];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and the density of lipid core burden index (lipid core burden index\/4 mm, 144 [interquartile range, 60\u2013285] versus 26 [interquartile range, 0\u201386];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) were higher in DES compared with bare-metal stents. Topographically, NA was classified as I (thin-cap NA), II (thick-cap NA), and III (peri-strut NA). Type I thin-cap neoatheroma was more common in DES (20% versus 3%;\n              <jats:italic>P<\/jats:italic>\n              =0.01) and in areas of the stented segment without significant in-stent restenosis (71%). Periprocedural myocardial infarction occurred only in DES (11 versus 0;\n              <jats:italic>P<\/jats:italic>\n              =0.05), of which 6 (55%) could be attributed to segments with &gt;70% in-stent restenosis. By logistic regression, prior DES was the only independent predictor of both NA (odds ratio, 7.0; 95% confidence interval, 1.7\u201327;\n              <jats:italic>P<\/jats:italic>\n              =0.006) and periprocedural myocardial infarction (odds ratio, 1.8; 95% confidence interval, 1.1\u20132.4;\n              <jats:italic>P<\/jats:italic>\n              =0.05).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In-stent thin-cap neoatheroma is more prevalent, is distributed more diffusely across the stented segment, and is associated with increased periprocedural myocardial infarction in DES compared with bare-metal stents. These findings support NA as a mechanism for late DES failure.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.112.000248","type":"journal-article","created":{"date-parts":[[2013,9,25]],"date-time":"2013-09-25T10:10:13Z","timestamp":1380103813000},"page":"507-517","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":68,"title":["Increased Thin-Cap Neoatheroma and Periprocedural Myocardial Infarction in Drug-Eluting Stent Restenosis"],"prefix":"10.1161","volume":"6","author":[{"given":"Ziad A.","family":"Ali","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Roleder","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagat","family":"Narula","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibhu D.","family":"Mohanty","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usman","family":"Baber","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason C.","family":"Kovacic","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary S.","family":"Mintz","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiyuki","family":"Otsuka","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Pan","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renu","family":"Virmani","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samin K.","family":"Sharma","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Moreno","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annapoorna S.","family":"Kini","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Mount Sinai School of Medicine, New York, NY (Z.A.A., T.R., J.N., B.D.M., U.B., J.C.K., S.K.S., P.M., A.S.K.); Division of Cardiology, Center for Interventional Vascular Therapy, Columbia University, New York, NY (Z.A.A., S.P.); Cardiovascular Research Foundation, New York, NY (Z.A.A., G.S.M.); and CV Path Institute, Gaithersburg, MD (F.O., R.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.693739"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.01.011"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circimaging.112.976167"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.110.988436"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2005.08.011"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/circinterventions.111.964965"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2008.06.001"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2009.05.001"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.12.001"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.187397"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.01.044"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000029927.92825.F6"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.104.531897"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehp433"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000159354.43778.69"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/circinterventions.111.963264"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.24.2915"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.10.909"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jes183"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.01.050"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.06.029"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV4I5A97"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.03.031"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.08.033"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.12.064"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192667"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.108.781377"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)92845-S"},{"key":"e_1_3_3_30_2","first-page":"552","article-title":"Detection of atherosclerotic progression with rupture of degenerated in-stent intima five years after bare-metal stent implantation using optical coherence tomography.","volume":"21","author":"Habara M","year":"2009","unstructured":"Habara M, Terashima M, Suzuki T. 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