Predictive Factors of Restenosis After Coronary Stent Placement
Key result
Diabetes is linked to ~86% higher coronary in-stent restenosis risk alongside procedural and vessel factors.
- OR 1.86
- 95% CI 1.56-2.16
- n=1,349
Why the study?
What clinical, lesional, and procedural factors predict restenosis after coronary stent placement?
Population
1,349 patients with successful coronary stent placement and no major adverse cardiac event during the first…
Design
Cohort
Follow-up
6 months
Authors
Discussion
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Implication
Diabetes, multiple stents, and smaller final minimal lumen diameter are strong independent predictors of restenosis after coronary stenting.
Key Points
- To identify clinical, angiographic, and procedural factors that predict restenosis and repeat revascularization after coronary stent placement.
- Prospective cohort study evaluating 1,349 eligible patients (1,753 lesions) who underwent successful coronary stent placement without major adverse cardiac events in the first 30 days.
- Six-month follow-up angiography was completed in 1,084 patients (1,399 lesions; 80.4%) to evaluate binary restenosis (≥50% diameter stenosis), late lumen loss, and target lesion revascularization (TLR).
- Multivariate analysis identified diabetes mellitus (binary restenosis OR 1.86, 95% CI [1.56, 2.16]; TLR OR 1.45, 95% CI [1.11, 1.80]) and multiple stents (binary restenosis OR 1.81, 95% CI [1.55, 2.06]; TLR OR 1.94, 95% CI [1.66, 2.22]) as independent predictors of restenosis.
- A post-procedure minimal lumen diameter <3 mm significantly increased risks of binary restenosis (OR 1.81, 95% CI [1.55, 2.06]) and TLR (OR 2.05, 95% CI [1.77, 2.34]).
- Classification tree analysis showed restenosis rates varied from 16% in lesions with no adverse factors to 59% when diabetes, multiple stents, and smaller post-procedure diameter co-occurred.
Study Design
Type
Cohort (n=1,349)
Structured PICO
What clinical, lesional, and procedural factors predict restenosis after coronary stent placement?
P
Population
1,349 patients with successful coronary stent placement and no major adverse cardiac events in the first 30 days, with angiographic follow-up at 6 months.
E
Exposure
Coronary stent placement (assessment of clinical, lesional, and procedural predictors of restenosis)
O
Outcome
Restenosis at 6 months (evaluated as binary restenosis ≥50% diameter stenosis, late lumen loss, and target lesion revascularization)surrogate
Main Result
Odds Ratio: 1.86 (95% CI 1.56–2.16)
Diabetes, multiple stents, and smaller final minimal lumen diameter are strong independent predictors of restenosis after coronary stenting.
Cite This Study
Kastrati et al. (1997) conducted a cohort in Coronary artery disease post-stenting (n=1,349). Diabetes mellitus vs. Absence of diabetes was evaluated on Binary restenosis (diameter stenosis ≥50%) (OR 1.86, 95% CI 1.56-2.16). Diabetes, multiple stents, and a minimal lumen diameter <3 mm strongly predicted restenosis after coronary stenting, with diabetes increasing binary restenosis risk (OR 1.86; 95% CI 1.56-2.16).