• NEWS . 05 Oct 2020
  • Early DES-ISR and left ventricular systolic dysfunction associated with MACE

  • The mechanism and characteristics of early and late drug-eluting stent in-stent restenosis (DES-ISR) have not been fully defined. Particularly, it remains unclear whether outcomes among these patients would be different irrespective of their repeated treatments.

    Considering this, a study sought to evaluate the associations between patient characteristics and clinical performance, as well as clinical outcomes after a repeated percutaneous coronary intervention. A total of 250 patients were enrolled, all of whom underwent initial stent implantation and were then readmitted to the same hospital for recurrent significant DES-ISR in 2016. They were categorized as early ISR (<12 months; E-ISR; n=32) and late ISR (≥12 months; L-ISR; n=218).

    Both groups were largely similar in baseline characteristics, except for the period of ISR, initial pre-procedure thrombolysis in myocardial infarction and a few serum biochemical indicators. The incidence of major adverse cardiac events (MACE) and target lesion revascularization were significantly higher in the E-ISR group. After multivariate analysis, E-ISR (odds ratio [OR], 13.267; 95% confidence interval [CI], 4.984–35.311; p<0.001) and left ventricular systolic dysfunction (OR, 6.317; 95% CI, 1.145–34.843; p=0.034) were the independent predictors for MACE among DES-ISR patients in the mid-term follow-up of 12 months.

    Therefore, it can be concluded that early ISR and left ventricular systolic dysfunction were associated with MACE during the mid-term follow-up period for DES-ISR patients. These findings may have important clinical implications for the risk stratification and secondary prevention in DES-ISR patients. 

    Reference:
    Zheng JF, et al. Clinical characteristics of early and late drug-eluting stent in-stent restenosis and mid-term prognosis after repeated percutaneous coronary intervention. Chin Med J (Engl) 2020. doi:10.1097/CM9.0000000000001135. [Epub ahead of print].