Association Between Diabetes Mellitus and In-Stent Restenosis at a Military Hospital in Jakarta

Background: In-Stent Restenosis (ISR) refers to the recurrence of luminal narrowing within the stented segment after Percutaneous Coronary Intervention (PCI) and continues to pose a clinical challenge, especially in individuals with Diabetes Mellitus (DM). Elevated blood glucose levels lead to endothelial injury, persistent inflammation, and excessive neointimal tissue growth, all of which increase the likelihood of ISR. Methods: This research employed an analytical observational approach with a cross-sectional design and was conducted at a military hospital in Jakarta. Data were collected from the medical records of patients diagnosed with Coronary Artery Disease (CAD) who underwent PCI between January 2021 and December 2023. A total sampling method was applied to all patients who underwent PCI and had a clinically indicated follow-up coronary angiography during the study period, yielding 66 eligible patients. Bivariate analysis was performed using the Chi-square test, followed by multivariable logistic regression to adjust for relevant clinical covariates. Results: Of the 66 patients included in this study, 44 (66.7%) were diagnosed with DM, and 44 (66.7%) had ISR. Bivariate analysis showed that DM was significantly associated with ISR (OR 4.08; 95% CI: 1.36–12.21; p = 0.0097). Multivariate analysis showed that poor glycemic control remained independently associated with ISR (OR 5.39; 95% CI: 1.04–27.84; p = 0.044), while diabetes status alone was no longer independently associated. Conclusion: DM is associated with higher ISR after PCI, with poor glycemic control independently associated, underscoring the importance of optimized glycemic management.