Predictive factor of the third coronary stent restenosis

Cho, Jung Sun; Jeong, Myung Ho; Jeong, Seon Young; Choi, Myung Ja; Chung, Jong Won; Hwang, Seung Hwan; Lee, Sang Hyun; Kim, Kye Hun; Yun, Kyung Ho; Kang, Dong Ku; Hong, Seo Na; Lim, Sang Yup; Lee, Youn Sang; Hong, Young Joon; Park, Hyung Wook; Kim, Ju Han; Kim, Weon; Ahn, Young Keun; Cho, Jeong Gwan; Park, Jong Chun; Kang, Jung Chaee

Abstract

BACKGROUND: Percutaneous coronary intervention (PCI) has been established as one of the effective therapeutic methods in the treatment of ischemic heart disease. A coronary artery stent is the most promising device in PCI, however in-stent restenosis (ISR) remains a major problem to be overcome.
METHODS
Follow-up coronary angiograms (CAG) three times after stenting were performed in 107 out of 3,816 stented patients at Chonnam National University Hospital between August 1992 and July 2004. The patients were divided into four groups: forty eight patients (Group I: 58.7+/-9.5 years, 35 Males) had no incident ISR on three follow-up CAG. Fourteen patients had three times of ISR and underwent four PCIs (Group II : 54.5+/-9.51 years, 12 Males), 15 had two times of ISR and underwent three PCIs (Group III : 53.9+/-5.9 years, 11 males), 30 had one time of ISR and underwent two PCIs (Group IV : 59.6+/-9.5 years, 27 males). Each group was analysed according to clinical characteristics, coronary angiographic findings, and therapeutic modalities for ISR.
RESULTS
There was no differences in clinical diagnosis, lesion location, multi-vessel lesion and TIMI flow. Risk factors for atherosclerosis were not different except for diabetes mellitus. The incidence of diabetes mellitus was more common in Group II than in Group I (Group I: 22%, Group II: 57%, Group III: 46%, Group IV: 20%, Group I vs. Group II: p =0.023). Stent length and diameter were not different among four groups.
CONCLUSION
The only predictor of recurrent coronary stent restenosis more than three times is diabetes mellitus.