Risk factors associated with restenosis in patients with percutaneous coronary intervention

Abstract

ABSTRACT Objective: The objective of this study was to assess the risk factors associated with residual stenosis in patients with percutaneous transluminal coronary angioplasty (PTCA). Materials and Methods: A cross-sectional survey was conducted at a single health-care center among coronary artery disease patients who have undergone PTCA. Primary information including demographics and clinical characteristics, groups of pre- and postdilation balloons, and characteristics of culprits’ vessel flow were retrieved from medical records of each patient. Data were analyzed using descriptive and appropriate comparative statistics. Results: A total of 1000 patients were included in this study. The majority of patients were men (67.0%). Hypertension (HTN) and diabetes were the most common comorbid condition. Yukon Choice phosphorylcholine (PC)-elite (86.2%) was the most common stent used in patients with PTCA followed by Endeavor Sprint (12.7%). All of the patients (100%) underwent PTCA for single culprit vessel disease (SVD) while 30.2% of the patients underwent PTCA for two-vessel disease (2VD). The incidence of residual stenosis was 0.5% for SVD PTCA and 0.3% for 2VD PTCA. The 2VD group achieved thrombolysis in myocardial infarction flow Grade II postrevascularization in 98.6% of patients. Significant associations were observed between residual stenosis and various factors. HTN (odds ratio [OR]: 38.79, 95% confidence interval [CI]: 3.260-461.688; P = 0.004), diabetes mellitus (OR: 4.548, 95% CI: 0.036-63.948; P < 0.001), the use of a 0.014” × 190 cm guide (OR: 185.0, 95% CI: 25.922-1320.294; P < 0.001), and the presence of two-vessel disease (OR: 6.698, 95% CI: 1.221-36.749; P = 0.029) were found to be significantly associated with residual stenosis. Conclusion: Residual stenosis was observed in both SVD and 2VD PTCA however, presence of HTN and DM, and 2VD were identified as pronounced risk factors for residual stenosis.