Key result
In 68 Romanian patients with in-stent restenosis after STEMI, hypertension (61%), dyslipidemia (60%), and smoking (47%) were the most common risk factors, while only 11% reported recurrent angina.
Why the study?
Data investigating in-stent restenosis in Romanian patients undergoing PCI for STEMI were limited.
Observational (n=68)
No
Answers are grounded in this paper and cite their sources.
In-stent restenosis after STEMI is often asymptomatic and associated with common cardiovascular risk factors, highlighting the need for careful follow-up and risk factor management.
Background and aim. Coronary artery disease (CAD) is one of the most important causes of death worldwide. ST-elevation myocardial infarction (STEMI) is an acute form of presentation in patients with CAD. Percutaneous coronary intervention (PCI) is the treatment of choice in STEMI patients. Generally, a stent is placed after the culprit lesion is dilated in order to ensure the patency of the coronary artery. In-stent restenosis (ISR) is a possible chronic complication in this setting. The following study is one of the few of its kind, since it investigates ISR in a cohort of Romanian patients who underwent PCI in the setting of STEMI. Our current descriptive study aims at highlighting the characteristics of these patients and identifying potential risk factors in this specific population, which could be validated by a further larger study. Methods. We studied 68 patients from “Dr. Carol Davila” Central Military Emergency University Hospital in Bucharest, Romania, who presented with STEMI in 2016. The mean time for angiographic reevaluation was 111 days. Results. 94% (64) of the patients underwent primary PCI, while in 6% (4) of the cases thrombolysis was initially attempted before PCI. The most prevalent risk factors that we identified were: arterial hypertension (61%), dyslipidemia (60%) and smoking or history of smoking (47%). The anterior myocardial infarction was the most prevalent (49%). Only 6% of the patients had a documented history of CAD, while on the other hand chronic occlusions were observed in most patients (85%). Of note is that only 11% of the patients reported recurrent angina before the angiographic reevaluation. Conclusion. Common cardiovascular risk factors are also involved in ISR. Their poor management in the case of Romanian patients with STEMI increases the risk of ISR. The lack of symptoms in patients with ISR constitutes a warning sign for clinicians and shows that ISR is a complication which can be easily omitted. Therefore, its incidence is probably underestimated.
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Munteanu et al. (2021) conducted an observational in In-stent restenosis after ST-elevation myocardial infarction (n=68). Cardiovascular risk factors (hypertension, dyslipidemia, smoking) was evaluated on Prevalence of cardiovascular risk factors and clinical characteristics in patients with in-stent restenosis. In 68 Romanian patients with in-stent restenosis after STEMI, hypertension (61%), dyslipidemia (60%), and smoking (47%) were the most common risk factors, while only 11% reported recurrent angina.
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