What is the clinical evidence from this study?

Study design: Observational. Population: Clinical in-stent restenosis (n=2462). Intervention: Myocardial infarction presentation vs. Non-MI presentation. Primary outcome: Diffuse in-stent restenosis (p=<0.005).

January 1, 2006Circulation JournalOpen Access

Myocardial Infarction as a Presentation of Clinical In-Stent Restenosis

Q: What are the key findings of this study?

Among patients with clinical in-stent restenosis, 10.4% presented with myocardial infarction, which was associated with a more diffuse angiographic pattern of restenosis (72.7% vs 56.3%; p<0.005).

Q: What does this research mean for the field?

Among patients with clinical in-stent restenosis, approximately 10.4% present with myocardial infarction, a presentation associated with a more diffuse angiographic pattern of restenosis, renal failure, and initial acute coronary syndromes. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Among patients with clinical in-stent restenosis, 10.4% presented with myocardial infarction, which was associated with a more diffuse angiographic pattern of restenosis (72.7% vs 56.3%; p<0.005).

Population

212 consecutive patients who presented with clinical in-stent restenosis out of 2,462 patients who underwent…

Design

Cohort

Follow-up

average 205±23 days (median 124 days)

Authors

ANAtasu NayakLahey Hospital and Medical Center AKAkio KawamuraInternational University of Health and Welfare RNRichard W. NestoGeneral / Preventive / Lipids

Discussion

Member takes

Implication

Challenges gradual ISR progression model; observational data leaves open need for targeted post-stent surveillance studies.

Study Design

Type

Observational (n=2,462)

Structured PICO

Population

212 consecutive patients who presented with clinical in-stent restenosis (angiographic stenosis >50% within 5mm of the stented segment with clinical evidence of ischemia) out of 2,462 patients who underwent percutaneous coronary interventions with bare metal stents between June 2001 and December 2002.

Outcome

Incidence of myocardial infarction (MI) as a clinical presentation of in-stent restenosishard clinical

Main Result

Absolute Event Rate: 72.7% vs 56.3%

p-value: p=<0.005

Clinical in-stent restenosis can frequently present as myocardial infarction, particularly in patients with renal failure or those who had acute coronary syndromes at their initial procedure, and is associated with an aggressive angiographic pattern of restenosis.

Limitations

Retrospective analysis from a single center
Patient subset was limited to those who had recurrent symptoms and did not include patients with silent restenosis or ischemia
Angiographical analysis was performed visually by 2 experienced operators and not by an independent core laboratory with quantitative analysis
Intravascular ultrasound data were not available

Cite This Study

Nayak et al. (2006) conducted an observational in Clinical in-stent restenosis (n=2,462). Myocardial infarction presentation vs. Non-MI presentation was evaluated on Diffuse in-stent restenosis (p=<0.005). Among patients with clinical in-stent restenosis, 10.4% presented with myocardial infarction, which was associated with a more diffuse angiographic pattern of restenosis (72.7% vs 56.3%; p<0.005).

synapsesocial.com/papers/6a144d22f88db7183c59ee88 https://doi.org/10.1253/circj.70.1026

Topics

Dual antiplatelet therapy

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January 1, 2006Circulation JournalOpen Access

Myocardial Infarction as a Presentation of Clinical In-Stent Restenosis

View Full Paper

Ask AI

Bookmark

Key result

Among patients with clinical in-stent restenosis, 10.4% presented with myocardial infarction, which was associated with a more diffuse angiographic pattern of restenosis (72.7% vs 56.3%; p<0.005).

Population

212 consecutive patients who presented with clinical in-stent restenosis out of 2,462 patients who underwent…

Design

Cohort

Follow-up

average 205±23 days (median 124 days)

Authors

ANAtasu NayakLahey Hospital and Medical Center AKAkio KawamuraInternational University of Health and Welfare RNRichard W. NestoGeneral / Preventive / Lipids

Discussion

Member takes

Implication

Challenges gradual ISR progression model; observational data leaves open need for targeted post-stent surveillance studies.

Study Design

Type

Observational (n=2,462)

Structured PICO

Population

Outcome

Incidence of myocardial infarction (MI) as a clinical presentation of in-stent restenosishard clinical

Main Result

Absolute Event Rate: 72.7% vs 56.3%

p-value: p=<0.005

Limitations

Retrospective analysis from a single center
Patient subset was limited to those who had recurrent symptoms and did not include patients with silent restenosis or ischemia
Angiographical analysis was performed visually by 2 experienced operators and not by an independent core laboratory with quantitative analysis
Intravascular ultrasound data were not available

Cite This Study

synapsesocial.com/papers/6a144d22f88db7183c59ee88 https://doi.org/10.1253/circj.70.1026

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Dual antiplatelet therapy

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