Faculty Collaboration Database

Trends and Outcomes of Restenosis After Coronary Stent Implantation in the United States. J Am Coll Cardiol 2020 Sep 29;76(13):1521-1531

Date

09/26/2020

Pubmed ID

32972528

DOI

10.1016/j.jacc.2020.08.002

Scopus ID

2-s2.0-85090718760 (requires institutional sign-in at Scopus site)   109 Citations

Abstract

BACKGROUND: There is a paucity of data on the burden of in-stent restenosis (ISR) in the United States as well as on its presentation and appropriate treatment strategies.

OBJECTIVES: This study aims to provide an analysis of the temporal trends, clinical presentation, treatment strategies, and in-hospital outcomes of patients undergoing percutaneous coronary intervention (PCI) for ISR in the United States.

METHODS: This study is a retrospective analysis of data collected in the Diagnostic Catheterization and Percutaneous Coronary Intervention (CathPCI) registry of the National Cardiovascular Data Registry (NCDR) between 2009 and 2017. Of the total patients undergoing PCI, we identified those undergoing PCI for ISR lesions. For comparison of in-hospital outcomes, propensity-score matching was employed.

RESULTS: Among the 5,100,394 patients undergoing PCI, 10.6% of patients underwent PCI for ISR lesions. Patients with bare-metal stent ISR declined from 2.6% in 2009 Q3 to 0.9% in 2017 Q2 (p < 0.001), and drug-eluting stent ISR rose from 5.4% in 2009 Q3 to 6.3% in 2017 Q2 (p < 0.001). Patients with ISR PCI were less likely to present with non-ST-segment elevation myocardial infarction (MI) (18.7% vs. 22.5%; p < 0.001) or ST-segment elevation MI (8.5% vs. 15.7%; p < 0.001). In the propensity-matched population of patients, there were no significant differences between patients with ISR and non-ISR PCI for in-hospital complications and hospital length of stay.

CONCLUSIONS: ISR represents approximately 10% of all PCI and is treated most commonly with another stent. Approximately 25% of patients present with acute MI. In-hospital outcomes of patients with ISR PCI are comparable with those undergoing non-ISR PCI.

Author List

Moussa ID, Mohananey D, Saucedo J, Stone GW, Yeh RW, Kennedy KF, Waksman R, Teirstein P, Moses JW, Simonton C

Author

Divyanshu Mohananey MD Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Coronary Angiography
Coronary Restenosis
Female
Humans
Male
Middle Aged
Percutaneous Coronary Intervention
Postoperative Complications
Registries
Retrospective Studies
Stents
United States