Page 106 - GTM-3-4

Global Translational Medicine Prediction of in-stent restenosis

the meta-analysis by Zhang et al., in which the use of patients were probably lost to follow-up after leaving
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DES and drug-coated balloons was the only choice for the region, rendering them unavailable in the medical
de novo CAD, chronic coronary disease, and myocardial recording system.
35
infarction. The smaller the diameter of the revascularized
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vessel, the higher the risk of restenosis. Coronary 5. Conclusion
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stent < 3 mm was also identified by Zhang et al. as a risk Our systematic review analyzed the risk factors for coronary
factor for coronary restenosis. In this study, 350 patients restenosis, their influence on the frequency and rate of
with CHD after percutaneous coronary intervention were adverse events, and the corresponding favorable outcomes.
divided into a stent stenosis group and a stent non-stenosis The retrospective analysis revealed that the stent type and
group based on coronary angiography results performed stented artery diameter significantly affect the duration of
2 years after percutaneous coronary intervention. Of the stent function and the likelihood of restenosis. Developing
350 patients with CHD, 138 (39.43%) had stent restenosis, a mathematical model for predicting risk factors and
while 212 did not. Multivariate logistic regression analysis identifying new predictors of restenosis will improve the
revealed that family history of CHD, history of Type 2 prognosis in patients with recurrent coronary restenosis.
diabetes, hypertension, smoking, and drinking, aspirin
withdrawal, use of conventional doses of statins, calcified Acknowledgments
lesions, ≥3 implanted stents, stent length ≥30 mm, stent The authors are grateful to all CHD patients for their
diameter <3 mm, and tandem stenting were risk factors participation in this study, as well as the clinicians and
for in-stent restenosis within 2 years after percutaneous hospital staff of the Republic Cardiological Centre (Russia)
coronary intervention. A family history of CHD, history who contributed to this study.
of Type 2 diabetes, hypertension, smoking, and drinking,
discontinuation of aspirin, use of conventional dose statins, Funding
calcified lesions, ≥3 stent implantations, stent length
≥30 mm, stent diameter <3 mm, and tandem stenting None.
are risk factors for ISR within 2 years after percutaneous Conflict of interest
coronary intervention in patients with CHD.
Naufal Sh. Zagidullin is the Editorial Board Member of this
However, prior myocardial infarction and male sex journal and Guest Editor of this special issue but was not in
were less frequently identified as risk factors. Although any way involved in the editorial and peer-review process
DES reduced the occurrence of stent restenosis compared conducted for this paper, directly or indirectly. Separately,
with BMS, managing DES-restenosis is more challenging other authors declared that they have no known competing
and results in poorer long-term clinical and angiographic financial interests or personal relationships that could have
outcomes than BMS-associated restenosis. At present, influenced the work reported in this paper.
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both new-generation DES and drug-coated balloons are
recommended by the European guidelines on coronary Author contributions
revascularization for the treatment of patients presenting
with in-stent restenosis. 39 Conceptualization: Haibo Jia
Methodology: Igor Buzaev, Irina Lakman, Naufal Zagidullin
In-stent restenosis significantly aggravates CHD Investigation: Alina Enikeeva, Liutsiia Gazizova
prognosis. The 5-year survival rate of such patients is Resources: Irina Nikolaeva
reduced when treated with conservative therapy alone. These Writing – original draft: Alina Enikeeva, Liutsiia Gazizova
factors determine unfavorable prognosis, the need for repeat Writing – review & editing: Igor Buzaev, Tagir Aminov,
revascularizations, and the progression of heart failure. Elena Badykova
Consequently, the identification of restenosis predictors is
increasingly important, despite limited existing knowledge. Ethics approval and consent to participate
This could enable the development of personalized treatment The study was approved by the Ethics Committee of Bashkir
regimens, informed decisions on revascularization methods, State Medical University, Russia (Ufa, Protocol No 9;
material selection, and stenting techniques. November 17, 2021). The systematic review conducted in
Our study had several limitations. Despite the large this study was in accordance with the PRISMA protocol
sample size, the study was based on a single center, thus statement. The protocol was registered in (registration
limiting its findings to a specific region within the unique. platform, PROSPERO) under the ID (registration number
The study was not controlled, and no measures were 622760). All procedures carried out in the study involving
implemented to address selection bias. In addition, some patient participation complied with the ethical standards

Volume 3 Issue 4 (2024) 8 doi: 10.36922/gtm.4957