Key result
Among 768 patients hospitalized with ACS, 11.7% had a history of prior PCI, with bare metal stent implantation and dyslipidemia identified as common predictors of recurrent atherothrombotic events.
Why the study?
To evaluate the prevalence, clinical and endovascular predictors, causes, timing, clinical features, and lipid spectrum parameters of ACS in patients with prior PCI.
Observational (n=768)
No
Patients with prior PCI represent nearly 12% of ACS cases requiring emergency angiography, highlighting the need for optimal stent selection and aggressive lipid management.
Prior PCI accounts for ~12% of ACS cases with recurrence linked to bare metal stents and dyslipidemia; leaves open whether modern strategies reduce events.
Aim . To study the prevalence, clinical and endovascular predictors, causes and timing of the development of acute coronary syndrome (ACS) in patients who had previously undergone percutaneous coronary intervention (PCI), as well as the clinical features of the disease and lipid spectrum parameters. Material and methods . The prospective study included 768 patients successively hospitalized from 01.01.2019 to 01.01.2020 in the Regional cardiovascular center, undergoing to emergency coronary angiography. Results . The main group included 768 patients who underwent emergency coronary angiography for ACS. 90 of them had previously undergone PCI (11.7%). Men prevailed (66.7%), the average age was 62 years. 25.5% of patients underwent ACS within a year after coronary stenting, the mean time from PCI to ACS was 43 months. Most often, there was ACS without ST segment elevation (80%). The results of a retrospective analysis of the first PCI showed that 89.7% of patients underwent urgent PCI, 77.8% of patients received bare metal stents. In 67.1% of patients, 1 stent was implanted, the average diameter was 3.2 mm, the average length was 22 mm. Thromboaspiration was performed in 12% of cases, predilatation in 25%, and NC postdilation in 41.3% of cases. Complications of PCI developed in 9% of patients. Stent thrombosis was diagnosed in 7.8% of cases, significant restenosis in 35.6%. Repeated stenting due to ACS was performed in 64.4% of patients, of which 74.6% received 1 stent; average diameter 3.4 mm, average length 24.0 mm. Predilatation was performed in 52.9% of cases, thromboaspiration – in 41.2%, and NC-postdilation – in 86.7% of cases. Complications of PCI developed in 10%. In addition, 99% of patients had significant dyslipidemia. The average cholesterol level was 4.91 mmol/L, the average low-density lipoprotein level was 2.94 mmol/L. Conclusion . Patients after PCI are 12% of group with ACS in clinical practice of the Regional Vascular Center. The most common predictor of recurrent atherothrombotic events is bare metal stent implantation as well as dyslipidemia.
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Egorova et al. (2023) conducted an observational in Acute Coronary Syndrome (n=768). Prior percutaneous coronary intervention (PCI) was evaluated on Prevalence of prior PCI among patients presenting with ACS. Among 768 patients hospitalized with ACS, 11.7% had a history of prior PCI, with bare metal stent implantation and dyslipidemia identified as common predictors of recurrent atherothrombotic events.
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