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Prevalence of Drug Eluting Stent Restenosis and Its Correlation with Culprit Coronary Artery

Received: 20 August 2018     Accepted: 18 September 2018     Published: 29 November 2018
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Abstract

In-Stent Restenosis (ISR) remains a significant problem for the treatment of coronary artery disease (CAD). Our study was conducted to evaluate the prevalence of significant restenosis of drug eluting stent (DES), as to its correlation with the culprit coronary artery. A retrospective study was conducted on 924 consecutive patients undergoing percutaneous coronary intervention (PCI) for DES implantation and who were followed-up by cardiac coronarography within 1 year. Cardiac coronarography films were reviewed for the presence or the absence of significant ISR, and for detection of the underlying culprit coronary artery. 2x2 tables and Chi square test were used. P value<0.05 was considered significant. The revision of cardiac coronarography films of follow-up for 924 included angioplasties showed significant ISR in 165 DES out of the 1494 implanted ones. Statistical analysis estimates the prevalence of DES restenosis at 11%. Taking into consideration the different coronary arteries, it is respectively: 8.79% in Left Anterior Descending (LAD) where ISR was found in 63 stents out of the 654 inserted ones, 11.38% in circumflex (Cx) where ISR was found in 42 stents out of the 327 inserted ones, and 14.7% in right coronary artery (RCA) where ISR was found in 60 stents out of the 342 implanted ones. A negative significant relationship was detected between the prevalence of ISR and LAD coronary artery lesion in opposition to a positive significant relationship between the prevalence of ISR and RCA lesion. The prevalence of significant ISR of DES is 11% and it is significantly higher in stents implanted in RCA as compared to stents implanted in Cx and LAD with statistical evidence of significant correlation between the prevalence of ISR and the involved culprit coronary artery.

Published in Cardiology and Cardiovascular Research (Volume 2, Issue 4)
DOI 10.11648/j.ccr.20180204.11
Page(s) 75-78
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

In-Stent Restenosis, Drug Eluting Stent, Coronary Artery Disease, Percutaneous Intervention

References
[1] Matta A, Moussallem N. Evolution of the prevalence of angiographically significant coronary artery disease in lebanese population referred to cardiac catheterization. Lebanese Medical Journal 2017; 65 (4): 205-207.
[2] Bharadwaj B, Chadha G. Drug eluting stents: to evolve or dissolve? Medical Journal Armed Forces India 2016; 72 (4): 367-372.
[3] Hamid H, Coltart J. ’Miracle stents’-a future without restenosis. McGill J Med 2007; 10(2): 105-111.
[4] Jukema J, Verschuren J, Quax P. Restenosis after PCI. Part1: pathophysiology and risk factors. Nature Reviews Cardiology 2012; 9: 53-62.
[5] Byrne R, Joner M, Kastrati A. Stent thrombosis and restenosis: what have we learned and where are we going? The Andreas Gruntzig lecture ESC 2014. Eur heart J.2015 Dec 14; 36(47):3320-3331.
[6] Moses JW, Leon MB, Popma JJ, et al. Sirolimus- eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med 2003; 349:1315-23.
[7] Buccheri D, Piraino D, Andolina G, Cortese B. Understanding and managing in-stent restenosis: a review of clinical data, from pathogenesis to treatment. J Thoracic Dis.2016 Oct; 8(10): E1150- E1162.
[8] Goto K, Zhao Z, Matsumura M, et al. Mechanisms and Patterns of Intravascular Ultrasound In-Stent Restenosis Among Bare Metal Stents and First- and Second- Generation Drug-Eluting Stents. Am J Cardiol 2015; 116:1351-7.
[9] Alfonso F, Byrne R, Rivero F, Kastrati A. Current treatment of in-stent restenosis. Journal of the American College of Cardiology 2014; 63(24).
[10] Dangas GD, Claessen BE, Caixeta A, Sanidas EA, Mintz GS, Mehran R. In-stent restenosis in the drug-eluting stent era. 2010; 56 (23)1897-907.
[11] Giacoppo D, Gargiulo G, Aruta P, Capranzano P, Tamburino C, Capodanno D. Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-ansalysis of 24 randomised trials and 4880 patients. BMJ 2015; 351.
[12] Buccheri D, Piraino D, Andolina G, CorteseB. Understanding and managing in-stent restenosis: a review of clinical data, from pathogenesis to treatment. Journal of Thoracic Disease 2016; 8(10): E1150-E1162.
[13] Cassese S, Byrne RA, Tada T, et al. Incidence and predictors of restenosis after coronary stenting in 10004 patients with surveillance angiography. Heart 2014; 100: 153-9.
[14] Zhao LP, Xu WT, Wang L, et al.Influence of insulin resistance on in-stent restenosis in patients undergoing coronary drug-eluting stent implantation after long-term angiographic follow-up.Coron Artery Dis 2015; 26: 5-10.
Cite This Article
  • APA Style

    Anthony Matta, Joseph Bou Assi, Alexandre Kharma, Nicolas Moussallem. (2018). Prevalence of Drug Eluting Stent Restenosis and Its Correlation with Culprit Coronary Artery. Cardiology and Cardiovascular Research, 2(4), 75-78. https://doi.org/10.11648/j.ccr.20180204.11

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    ACS Style

    Anthony Matta; Joseph Bou Assi; Alexandre Kharma; Nicolas Moussallem. Prevalence of Drug Eluting Stent Restenosis and Its Correlation with Culprit Coronary Artery. Cardiol. Cardiovasc. Res. 2018, 2(4), 75-78. doi: 10.11648/j.ccr.20180204.11

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    AMA Style

    Anthony Matta, Joseph Bou Assi, Alexandre Kharma, Nicolas Moussallem. Prevalence of Drug Eluting Stent Restenosis and Its Correlation with Culprit Coronary Artery. Cardiol Cardiovasc Res. 2018;2(4):75-78. doi: 10.11648/j.ccr.20180204.11

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  • @article{10.11648/j.ccr.20180204.11,
      author = {Anthony Matta and Joseph Bou Assi and Alexandre Kharma and Nicolas Moussallem},
      title = {Prevalence of Drug Eluting Stent Restenosis and Its Correlation with Culprit Coronary Artery},
      journal = {Cardiology and Cardiovascular Research},
      volume = {2},
      number = {4},
      pages = {75-78},
      doi = {10.11648/j.ccr.20180204.11},
      url = {https://doi.org/10.11648/j.ccr.20180204.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20180204.11},
      abstract = {In-Stent Restenosis (ISR) remains a significant problem for the treatment of coronary artery disease (CAD). Our study was conducted to evaluate the prevalence of significant restenosis of drug eluting stent (DES), as to its correlation with the culprit coronary artery. A retrospective study was conducted on 924 consecutive patients undergoing percutaneous coronary intervention (PCI) for DES implantation and who were followed-up by cardiac coronarography within 1 year. Cardiac coronarography films were reviewed for the presence or the absence of significant ISR, and for detection of the underlying culprit coronary artery. 2x2 tables and Chi square test were used. P value<0.05 was considered significant. The revision of cardiac coronarography films of follow-up for 924 included angioplasties showed significant ISR in 165 DES out of the 1494 implanted ones. Statistical analysis estimates the prevalence of DES restenosis at 11%. Taking into consideration the different coronary arteries, it is respectively: 8.79% in Left Anterior Descending (LAD) where ISR was found in 63 stents out of the 654 inserted ones, 11.38% in circumflex (Cx) where ISR was found in 42 stents out of the 327 inserted ones, and 14.7% in right coronary artery (RCA) where ISR was found in 60 stents out of the 342 implanted ones. A negative significant relationship was detected between the prevalence of ISR and LAD coronary artery lesion in opposition to a positive significant relationship between the prevalence of ISR and RCA lesion. The prevalence of significant ISR of DES is 11% and it is significantly higher in stents implanted in RCA as compared to stents implanted in Cx and LAD with statistical evidence of significant correlation between the prevalence of ISR and the involved culprit coronary artery.},
     year = {2018}
    }
    

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  • TY  - JOUR
    T1  - Prevalence of Drug Eluting Stent Restenosis and Its Correlation with Culprit Coronary Artery
    AU  - Anthony Matta
    AU  - Joseph Bou Assi
    AU  - Alexandre Kharma
    AU  - Nicolas Moussallem
    Y1  - 2018/11/29
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    N1  - https://doi.org/10.11648/j.ccr.20180204.11
    DO  - 10.11648/j.ccr.20180204.11
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
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    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20180204.11
    AB  - In-Stent Restenosis (ISR) remains a significant problem for the treatment of coronary artery disease (CAD). Our study was conducted to evaluate the prevalence of significant restenosis of drug eluting stent (DES), as to its correlation with the culprit coronary artery. A retrospective study was conducted on 924 consecutive patients undergoing percutaneous coronary intervention (PCI) for DES implantation and who were followed-up by cardiac coronarography within 1 year. Cardiac coronarography films were reviewed for the presence or the absence of significant ISR, and for detection of the underlying culprit coronary artery. 2x2 tables and Chi square test were used. P value<0.05 was considered significant. The revision of cardiac coronarography films of follow-up for 924 included angioplasties showed significant ISR in 165 DES out of the 1494 implanted ones. Statistical analysis estimates the prevalence of DES restenosis at 11%. Taking into consideration the different coronary arteries, it is respectively: 8.79% in Left Anterior Descending (LAD) where ISR was found in 63 stents out of the 654 inserted ones, 11.38% in circumflex (Cx) where ISR was found in 42 stents out of the 327 inserted ones, and 14.7% in right coronary artery (RCA) where ISR was found in 60 stents out of the 342 implanted ones. A negative significant relationship was detected between the prevalence of ISR and LAD coronary artery lesion in opposition to a positive significant relationship between the prevalence of ISR and RCA lesion. The prevalence of significant ISR of DES is 11% and it is significantly higher in stents implanted in RCA as compared to stents implanted in Cx and LAD with statistical evidence of significant correlation between the prevalence of ISR and the involved culprit coronary artery.
    VL  - 2
    IS  - 4
    ER  - 

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Author Information
  • Cardiovascular Department, Notre-Dame des Secours University Hospital, Jbeil, Lebanon

  • Faculty of Medicine, Holy Spirit University of Kaslik, Kaslik, Lebanon

  • Cardiovascular Department, Notre-Dame des Secours University Hospital, Jbeil, Lebanon

  • Cardiovascular Department, Notre-Dame des Secours University Hospital, Jbeil, Lebanon

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