Antiplatelet therapy and inflammatory status associated with intra‑stent restenosis after percutaneous coronary intervention

The present study analyzed the existence and quantification of inflammatory status and antiplatelet medication associated with intra‑stent restenosis (ISR) in coronary artery disease (CAD) patients after percutaneous coronary inter­vention (PCI). Material and methods: an observational cross‑sectional study was conducted in a high‑volume PCI centre over a 2-year period. A total of 235 consecutive patients diagnosed with angina or acute coronary syndrome treated by PCI were included in the study. Diagnosis of ISR was documented by coronary angiography and the patients were divided into groups (with and without ISR). All patients underwent clinical and laboratory examination, the administration of antiplatelet medication and the type of drug administered to each patient. Results: The mean time until ISR was 33 ± 34 weeks. The lower use of single or dual antiplatelet therapy was associated with increased risk of ISR. Aspirin alone [risk ratio (RR)=1.13; 95% confidence interval (95% CI): 0.882‑1.462], clopidogrel alone (RR = 1.41; 95% CI: 0.879- 0.323), ticagrelor alone (RR = 1.98; 95% CI: 1.746-2.252) or dual antiplatelet therapy (DAPT) (RR = 0.82; 95% CI: 0.637-1.065) had a significant role in estimating the risk for ISR. Bare-metal stents (BMS) presented an associated risk of ISR higher as compared to drug-eluting stents (DES) (0.88 vs. 0.74). Conclusions: Inflammatory status is associated with ISR; the type of stent used, time to ISR and antiplatelet medication were found to be associated with ISR.