Impact of preprocedural high-sensitivity C-reactive protein levels on uncovered stent struts: An optical coherence tomography study after drug-eluting stent implantation

Background There are no sufficient data to evaluate the relationship between high-sensitivity C-reactive protein (hs-CRP) and uncovered stent struts on optical coherence tomography (OCT) after drug-eluting stent (DES) implantation. Hypothesis We evaluated the relationship between the preprocedural level of hs-CRP and incomplete neointimal coverage of DES struts on OCT. Methods This study was conducted using 124 eligible patients (132 lesions) treated with sirolimus-eluting stents (SES) or zotarolimus-eluting stents (ZES). The subjects were divided into 2 groups based on the preprocedural hs-CRP level: high-CRP (≥3 mg/L; 58 lesions) and normal-CRP (<3 mg/L, 74 lesions) groups. The percentage of uncovered struts, calculated as the ratio of uncovered struts to total struts in all OCT cross-sections, was compared between the 2 groups according to initial clinical presentation (stable angina [SA] vs acute coronary syndrome) and the type of implanted DES (SES vs ZES). Results There was no significant correlation between hs-CRP and the percentage of uncovered struts on OCT in all enrolled lesions. In the SA subgroup, the percentage of uncovered struts was significantly higher in the high-CRP group than in the normal-CRP group (8.1 ± 11.6% vs 3.8 ± 7.9%, P = 0.018). There was significant correlation between hs-CRP level and the percentage of uncovered struts in SA patients with SES (r = 0.280, P = 0.039), but not ZES (r = - 0.063, P = 0.729). Conclusions Preprocedural hs-CRP level could affect incomplete neointimal coverage of struts after DES implantation depending on the initial clinical presentation and the type of implanted DES.