Key result
DCB angioplasty is associated with ~35% recurrent in-stent restenosis, predicted by high RDW and cutting balloons.
Why the study?
Recurrent in-stent restenosis (RISR) after drug-coated balloon (DCB) angioplasty is a primary cause of acute coronary syndrome recurrence requiring multiple revascularizations, but its incidence and predictors remain to be clarified.
Cohort (n=136)
No
In patients treated with drug-coated balloons for in-stent restenosis, over one-third developed recurrent restenosis, which was independently predicted by high baseline RDW, high pre-procedural stenosis, and the use of cutting balloons.
Recurrent ISR after DCB should not yet change practice; hypothesis-generating for RDW and procedural predictors in future trials.
Background: The efficacy and safety of DCB in treating ISR lesions has been widely validated, and the recurrence of ISR (RISR) emerges as one of the primary causes of recurrence of acute coronary syndrome that results in the requirement for multiple revascularizations. Methods: This retrospective study enrolled patients with ISR lesions who were successfully treated by DCB in the First Affiliated Hospital of Zhengzhou University from September 2018 to September 2021. All patients during rehospitalization received the coronary angiography. According to whether there was RISR, the enrolled patients were divided into recurrent in-stent restenosis group (RISR group) and non-recurrent in-stent restenosis group (non-RISR group). The comparison of the basic data, laboratory parameters and the quantitative coronary angiography data at operation and follow-up between the two groups was caried out. According to RISR, multivariate logistic regression analysis was performed on the statistically significant baseline variables for further analysis. Results: A total of 136 patients (147 ISR lesions) were enrolled in the study, 35.4% (52 lesions) developed RISR at follow-up, which lasted 13.6±8.5 months in average.Multivariate analysis revealed the independent association of high RDW, high % DS before procedure and the use of cutting balloon with RISR after DCB angioplasty(P<0.05). Conclusion: At least 1/3 of patients with ISR lesions develop RISR after DCB dilation. High baseline RDW, high %DS before procedure, and the use of cutting balloon were identified as independent predictors of RISR.
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Liu et al. (2023) conducted a cohort in In-stent restenosis (n=136). Drug-coated balloon angioplasty was evaluated on Recurrent in-stent restenosis (RISR). Recurrent in-stent restenosis occurred in 35.4% of lesions after drug-coated balloon angioplasty, with high baseline RDW, high pre-procedural diameter stenosis, and cutting balloon use as predictors.
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