Factores predictores de reestenosis intra-stent

Abstract

Stenting has contributed to improve the early angiographic result, the restenosis rate and the problem of acute and subacute coronary occlusion. In spite of this, the restenosis phenomenon still remains a problem to be completely solved. The aim of the study was to identify clinical, angiographical and procedural factors that are predictive of in-stent restenosis after successful implantation of coronary stent. We retrospectively analyzed 202 lesions, in 176 consecutive patients who underwent stent implantation with success in our hospital between January 1995 and August 1998. All patients had a clinical follow-up and an angiography after six months of stent implantation. From 202 lesions evaluated, 47 evolved with restenosis (23%). The only independent predictive variables were: to be receiving hypolipemiant treatment before stenting (OR: 0.3; IC: 0.1-0.8), the use of high pressure for stent implantation (OR: 0.4; IC: 0.2-0.9), to implant stent in < 3.1 mm (OR: 2.2; IC: 1.1-4.5) and to have a residual stenosis > 30% after stenting (OR: 13; IC: 1.5-120). The only statistical variables associated with in-stent restenosis phenomenon were: be under hypolipemiant treatment before the procedure and the use of high pressures for stent implantation; while risk factors arose: to implant stent in vessels < 3.1 mm and suboptimal angiography result after stenting.