Coronary In-Stent Restenosis: Predictors and Treatment

Ullrich, Helen; Olschewski, Maximilian; Münzel, Thomas; Gori, Tommaso

doi:10.3238/arztebl.m2021.0254

Cited by 34 publications

(40 citation statements)

References 50 publications

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“…Although previous studies [ 19 ] have shown that type of stent implantation, diabetes, prior bypass surgery, and small vessel diameter are predictors of ISR. However, this study found that the independent risk factors for ISR in different ethnic groups were not the same and that there were also some protective factors.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Stent Restenosis in Han and Uygur Patients with Coronary Heart Disease after PCI in the Xinjiang Region

Wang

Yang

Zhang

et al. 2022

Cardiology Research and Practice

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Background. Stent restenosis after PCI seriously affects the efficacy and prognosis; therefore, the study of ISR risk factors has become an urgent topic to be solved. Objective. To investigate the risk factors for in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) in Han and Uygur patients with coronary heart disease. Methods. The clinical data of 345 Han and 127 Uygur patients who underwent intracoronary stent implantation were divided into an ISR group and a non-ISR group. The general clinical data, laboratory indicators, and coronary artery lesions were compared. Results. Age (OR = 1.040, 95% CI: 1.006∼1.075), triglycerides (OR = 1.440, 95% CI: 1.050∼1.973), total cholesterol (OR = 5.256, 95% CI: 2.826∼9.773), and ApoB (OR = 137.540, 95% CI: 11.364∼899.455) were independent risk factors for ISR after PCI in the Han patients, while ApoAI (OR = 0.002, 95% CI: 0.001∼0.011), MCV (OR = 0.824, 95% CI: 0.744∼0.911), MCH (OR = 0.421, 95% CI: 0.324∼0.548), and MCHC (OR = 0.934, 95% CI: 0.903∼0.965) were protective factors of ISR after PCI in Han patients, and the logistic regression equation composed of various factors predicted that the area under the ROC curve of ISR was 0.905. ApoB (OR = 11.571, 95% CI: 1.667∼80.340), Gensini score (OR = 1.017, 95% CI: 1.003∼1.031), and diabetes history (OR = 3.474, 95% CI: 1.189∼10.151) were independent risk factors for ISR after PCI in Uygur patients, and the area under ROC curve of ISR predicted by logistic regression equation is 0.807. The predictive efficiency of the Gensini score and ApoB level for ISR in Uygur patients was higher than that in Han, while the predictive efficiency of levels of ApoAI and MCH for ISR in Han patients was higher than that in Uygur ( P < 0.05 ). Conclusion. The independent risk factors for ISR after PCI in Han and Uygur patients in Xinjiang are different.

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Section: Discussionmentioning

confidence: 99%

Predictors of Stent Restenosis in Han and Uygur Patients with Coronary Heart Disease after PCI in the Xinjiang Region

Wang

Yang

Zhang

et al. 2022

Cardiology Research and Practice

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“…From our results, we concluded that the minimum stent diameter was negatively associated with the occurrence of ISR after PCI in older ACS patients, however, there were many other factors affecting ISR, which also have different influence values in different groups, because the pathogenesis of ISR is multifactorial. 27 …”

Section: Discussionmentioning

confidence: 99%

Predictive Value Analysis of in-Stent Restenosis Within Three Years in Older Acute Coronary Syndrome Patients: A Two-Center Retrospective Study

Zhou

Chai

Dai

et al. 2022

Clin Appl Thromb Hemost

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We aimed to investigate prognostic factors of in-stent restenosis (ISR) within 3 years in older acute coronary syndrome (ACS) patients after drug-eluting stent (DES) implantation and establish a clinical model for predicting ISR. We retrospectively collected 215 older ACS patients who followed coronary angiography (CAG) after DES implantation, divided into ISR group and non in-stent restenosis (non-ISR) group according to the results of reviewed CAG. Logistic regression analysis was performed to screen independent predictors related to ISR and build the clinical predictive model, which clinical application was assessed by decision curve analysis (DCA) and clinical impact curve (CIC). Kaplan-Meier survival curves for ISR by independent predictors. In multivariate logistic regression analysis showed that the red cell distribution width (RDW) was higher in ISR group compared with non-ISR (odds ratio (OR) = 1.54, 95% confidence interval (CI): 1.14–2.08, p < 0.01). Instead, a negative correlation was observed between minimum stent diameter and ISR (OR = 0.28, 95%CI:0.09-0.86, p = 0.03). A novel nomogram composed of these significant features presented a concordance index (C-index) of 0.710, DCA and CIC suggested that the predictive nomogram had clinical utility. Schoenfeld residuals showed the model RDW ≥ 12.6% with minimum stent diameter <3 mm was consistent with the proportional risk assumption. The Kaplan-Meier estimate for ISR showed statistical significance. Higher levels of RDW and lower minimum stent diameter were associated with incidence of ISR within 3 years in older ACS patients after DES implantation.

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“…After PTCA with DES placement, DAPT is the standard of care to prevent in stent restenosis, which could occur up to 2–10% [12] . In light of this evidence our patient was firstly investigated with coronarography after the onset of acute epigastric abdominal pain and only after worsening abdominal pain, anemia and hypotension performed contrast enhancement CT scan demonstrating ASR [13] .…”

Section: Discussionmentioning

confidence: 99%

A case report of atraumatic splenic rupture after coronary stenting and dual antiplatelet therapy: Causality or relationship?

Boccanelli

Materazzo

Venditti

et al. 2021

International Journal of Surgery Case Reports

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Coronary In-Stent Restenosis: Predictors and Treatment

Cited by 34 publications

References 50 publications

Predictors of Stent Restenosis in Han and Uygur Patients with Coronary Heart Disease after PCI in the Xinjiang Region

Predictors of Stent Restenosis in Han and Uygur Patients with Coronary Heart Disease after PCI in the Xinjiang Region

Predictive Value Analysis of in-Stent Restenosis Within Three Years in Older Acute Coronary Syndrome Patients: A Two-Center Retrospective Study

A case report of atraumatic splenic rupture after coronary stenting and dual antiplatelet therapy: Causality or relationship?

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