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Study of Clinico-Etiological Profile of Patients with in-Stent Restenosis in Population of Western India

Rakesh Tirmale Senior Resident, Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016, India , Sharad Jain , Rakesh Tirmale , Krutika Patel , Keyur Patel , Kamal Sharma , Vishal Sharma , Mandip Tilara , Zeeshan Mansuri ,

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Journal of Cardiovascular Medicine and Surgery 4(3):p 241-248, Jul-Sep 2018. | DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4318.9

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Abstract

Background: Drug-eluting stents (DES) represent a significant improvement in the treatment of coronary artery disease as they decrease restenosis rates by approximately 50% compared with bare-metal stents. The study aimed to evaluate clinical, etiological factors and angiographic characteristics associated with occurrence of In-stent restenosis in of Bare metal (BMS) vs. Drug eluting stents. Methods and Results: The study included 200 patients of percutaneous coronary angioplasty during October 2014 to June 2016.Mean age of patients was 58.06±8.79 years with 140 (70%) were males and 60 (30%) were females. BMSand DES ISR (44.1% vs 56.3%) were diabetic (DM), (61% vs 84.4%) were hypertensive, (77.9% vs 56.3%) were dyslipidemic, (46.3% vs 21.9%) were smokers consecutively. Amongst the above risk factors, Diabetes (p-value 0.01) and smoking (p-value 0.028) were the two factors which had statistically significant correlation with severity of In-stent restenosis(ISR). Patients with BMS had more Non Focal ISR 98 (79.03%) than focal ISR 38 (50%) and the difference was statistically significant (p value <0.001). There was statistically significant difference (p =<0.05) between the stent diameter and the severity of ISR with less than 2.5 mm Diameter stents associated with more Non focal ISR. Conclusion: ES appears to reduce restenosis and clinical end points and to be more cost effective than BMS. Patientrelated factors (i.e. sex, Diabetes, smoking) are important variables that affect restenosis and, hence, the appropriate selection of devices and patients is crucial.

 

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DOI: http://dx.doi.org/10.21088/jcms.2454.7123.4318.9

Keywords

Bare Metal Stent; Drug Eluting Stent; Restenosis; Risk Factor

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