Prevalence of In-Stent Restenosis in Patients having Drug Eluting Stents with Lengths Exceeding 40mm: A Single-Center Study

Abstract

Background: Coronary artery disease (CAD) remains a significant global health challenge, with percutaneous coronary intervention (PCI) being a primary treatment method. The use of long drug-eluting stents (DES) has been linked to varied outcomes, particularly concerning in-stent restenosis (ISR), which may be influenced by factors like stent length and patient comorbidities. Objective: To assess the prevalence of ISR in patients undergoing PCI with long DES (>40mm), considering patient demographics, comorbidities, and lesion characteristics. Methods: This cross-sectional study was conducted at Frontier Corps Teaching Hospital (FCTH) and Lady Reading Hospital in Peshawar, Pakistan, involving 102 patients. The study focused on the frequency of ISR post-angioplasty, particularly in relation to comorbid conditions such as diabetes and hypertension. Data collection included demographics, echocardiographic assessments, and detailed angiogram analysis. Statistical analysis was performed using SPSS version 23.0, with a significance threshold set at p<0.05. Results: The overall prevalence of ISR was found to be 18.63%. Diabetes and hypertension showed a significant association with ISR, with p-values <0.0015. The ISR frequencies for single vessel disease (SVCAD), double vessel disease (DVCAD), and triple vessel disease (TVCAD) were 26.32%, 31.58%, and 42.10%, respectively, with TVCAD showing a statistically significant association (p=0.0185). Conclusion: The study highlights a significant association between long DES and increased ISR rates, particularly in patients with complex coronary anatomies and multiple comorbidities. Shorter stents are recommended to potentially reduce restenosis and improve outcomes in CAD management.