Predictors of diffuse-type in-stent restenosis following drug-eluting stent implantation

Park,Chang-Bum; Park,Hoon-Ki

doi:10.3892/etm.2013.1024

Predictors of diffuse-type in-stent restenosis following drug-eluting stent implantation

Authors:
- Chang-Bum Park
- Hoon-Ki Park
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Affiliations: Department of Internal Medicine, Graduate School of Medicine, Kyung Hee University at Gangdong, Kyung Hee University, Seoul, Republic of Korea, Department of Internal Medicine, Seoul Veterans Hospital, Seoul, Republic of Korea
Published online on: March 21, 2013 https://doi.org/10.3892/etm.2013.1024
Pages: 1486-1490

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Abstract

Diffuse-type in-stent restenosis (ISR) is known to be associated with a higher rate of restenosis than focal‑type ISR. Therefore, it is clinically important to identify the determinants of diffuse-type ISR following drug-eluting stent (DES) implantation. We investigated the clinical, procedural and angiographic variables for predicting diffuse-type ISR following DES implantation. A total of 173 ISR lesions in 159 patients (diffuse-type: 61 lesions, focal‑type: 112 lesions) following DES implantation from February 2003 to May 2008 were included in this study. Clinical, procedural and quantitative coronary angiographic variables were analyzed to determine predictors of diffuse-type ISR following DES implantation. Univariate analysis showed that the absence of hypertension [odds ratio (OR), 0.493; 95% confidence interval (CI), 1.025-4.103, P=0.042], use of a paclitaxel-eluting stent (PES) (OR, 3.318; 95% CI, 1.730‑6.365, P<0.001) and smaller post‑stenting minimal luminal diameter (MLD; OR, 0.368, 95% CI, 0.168-0.808, P=0.013) were significantly associated with diffuse-type ISR. However, use of a PES (OR, 3.957; 95% CI, 1.977-7.922, P<0.001) and smaller post-stenting MLD (OR, 0.320; CI, 0.140-0.731, P=0.007) were only independent predictors of diffuse-type ISR by multivariate analysis. Diabetes was not a predictor of diffuse‑type ISR. The use of a PES and the post‑stenting MLD were related to diffuse-type ISR following DES implantation.

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