Abstract
Percutaneous coronary angioplasty (PCI) and stent implantation are the most common therapeutic strategies for coronary artery stenosis; however, in-stent restenosis (ISR) is one of its important challenges. Although in some studies, coronary artery disease (CAD) factors are deemed to be the causes of ISR, in some others, the relationship between CAD factors and ISR are not observed. Over the past ten years, there has been no review article on factors affecting the ISR. This article aimed to review the possible factors affecting ISR in patients undergoing PCI. This narrative review study was conducted on PubMed, Web of Science, Scopus, and Google Scholar databases between 1 January 1990 and 30 July 2017. After initial screening of 1728 retrieved articles, 1401 articles were excluded to due irrelevancy to the review; and finally, 39 papers were selected for data collection. Our study results showed that the site and length of implanted stent, hypertension and diabetes are the most probable factors affecting ISR. Further studies are required for evaluation of the effect of other possible risk factors such as genetic sequencing, obesity, chronic infections and hemoglobin A1C levels. [GMJ.2018;7:e961]
Highlights
Coronary artery disease (CAD), in particular, acute coronary syndrome, and stable angina are some of the most common causes of death in the world [1]
In a study of Taira et al carried out on 1432 patients undergoing stent implantation in two centers, the results showed that smokers more than non-smokers were significantly suffering from in-stent restenosis (ISR) [23]
Apart from the low statistical sample size that is always one of the possible reasons for the failure to find a significant relationship among variables, one issue that has not been considered in most studies is discussion on impact of other factors such as the type of stent, skills of cardiologists and medicinal purposes on the incidence of ISR.In some studies, one person had performed all stent implantation, but the majority of studies have not been mentioned in this issue
Summary
Coronary artery disease (CAD), in particular, acute coronary syndrome, and stable angina are some of the most common causes of death in the world [1]. Stent implantation during percutaneous coronary angioplasty (PCI) is one of the leading non-therapeutic treatments for coronary artery stenosis [1,2]. Factors Affecting in-stent restenosis after Coronary Angioplasty proliferation, and inflammation have been identified as the primary mechanisms of ISR after stent implantation [5,6,7,8]. Over the past ten years, there has been no review article on factors affecting the ISR It seems that a new review study could offer a better view to specialists toward the possible influential factors in the ISR.
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