Early in-stent restenosis after revascularization in patients with ST-elevation myocardial infarction

Abstract

Background and aim: Obstructive coronary disease is one of the most important causes of death worldwide. Percutaneous coronary intervention is one of the most important treatments of this pathology. Using of coronary artery stents represented a major advance in interventional cardiology. While bare metal stents (BMS) set the reference point for improved safety over balloon-angioplasty, first-generation drug-eluting stents demonstrated significant improvements in efficacy, but not necessarily safety, and further technologic developments have focused on optimizing both. Methods: We studied 228 patients with STEMI in the last 6 months, divided in 2 groups – in the first group are 122 patients (53.5%) who developed in stent restenosis and the second group has 106 patients had no signs of restenosis (46.5%). The mean time of performing the angiographic reevaluation was 111 days for the first group and 154 days for the second group. The clinical signs that indicate the need of coronary reevaluation was stable angina (116, 50.87%), acute coronary syndrome (58, 25.4%) and asymptomatic patients (64, 28.9%). The cardiovascular risk factors correlate with high risk of restenosis was diabetes (24.3% in first group and 12.2% in the second one, p=0.004), active smoking (p=0.010) and metabolic syndrome (p=0.003). The stent’s length >28mm, stent’s diameter ≤ 2.5 mm and chronic occlusion correlate with high risk of in-stent restenosis in BMS. Conclusion: Understanding the importance of risk factors control, will reduce the risk of restenosis, of other cardiovascular event, even sudden death.