Factors Affecting in-stent Restenosis in Patients Undergoing Percutaneous Coronary Angioplasty
AbstractPercutaneous coronary angioplasty (PCI) and stent implantation are the most common therapeutic strategies for coronary artery stenosis; however, in-stent restenosis (ISR) is one of its important challenges. Although in some studies, coronary artery disease (CAD) factors are deemed to be the causes of ISR, in some others, the relationship between CAD factors and ISR are not observed. Over the past ten years, there has been no review article on factors affecting the ISR. This article aimed to review the possible factors affecting ISR in patients undergoing PCI. This narrative review study was conducted on PubMed, Web of Science, Scopus, and Google Scholar databases between 1 January 1990 and 30 July 2017. After initial screening of 1728 retrieved articles, 1401 articles were excluded to due irrelevancy to the review; and finally, 39 papers were selected for data collection. Our study results showed that the site and length of implanted stent, hypertension and diabetes are the most probable factors affecting ISR. Further studies are required for evaluation of the effect of other possible risk factors such as genetic sequencing, obesity, chronic infections and hemoglobin A1C levels. [GMJ.2018;7:e961]
Abdallah MS, Wang K, Magnuson EA, Spertus JA, Farkouh ME, Fuster V, et al. Quality of life after PCI vs CABG among patients with diabetes and multivessel coronary artery disease: a randomized clinical trial. JAMA. 2013; 310(15): 1581-90.
Appleby CE, Mackie K, Džavík V, Ivanov J. Late outcomes following percutaneous coronary interventions: Results from a large, observational registry. Can J Cardiol. 2010; 26(7): e218-e24.
Arora RR, Konrad K, Badhwar K, Hollman J. Restenosis after transluminal coronary angioplasty: a risk factor analysis. Cathet Cardiovasc Diagn. 1990; 19(1): 17-22.
Beygui F, Varnous S, Montalescot G, Fernandez F, Collet JP, Leprince P, et al. Long-term outcome after bare-metal or drug-eluting stenting for allograft coronary artery disease. J Heart Lung Transplant. 2010; 29(3): 316-22.
Bauters C, Hubert E, Prat A, Bougrimi K, Van Belle E, McFadden EP, et al. Predictors of restenosis after coronary stent implantation. J Am Coll Cardiol. 1998; 31(6): 1291-8.
Dauerman HL, Baim DS, Cutlip DE, Sparano AM, Gibson CM, Kuntz RE, et al. Mechanical debulking versus balloon angioplasty for the treatment of diffuse in-stent restenosis. Am J Cardiol. 1998; 82(3): 277-84.
Glass CK, Witztum JL. Atherosclerosis: the road ahead. Cell. 2001; 104(4): 503-16.
Schillinger M, Exner M, Mlekusch W, Haumer M, Ahmadi R, Rumpold H, et al. Balloon angioplasty and stent implantation induce a vascular inflammatory reaction. J Endovasc Ther. 2002; 9(1): 59-66.
Bernat R, Szavits-Nossan J, Trbovic A, Kapov-Svilicic K, Sesto I, Sipic T. Relationship of genetic markers for atherosclerosis and long-term outcome after percutaneous coronary intervention with stenting. Coll Antropol. 2012; 36(4): 1385-90.
Dzavik V, Kharbanda R, Ivanov J, Ing DJ, Bui S, Mackie K, et al. Predictors of long-term outcome after crush stenting of coronary bifurcation lesions: importance of the bifurcation angle. Am Heart J. 2006; 152(4): 762-9.
Elbaz M, El Mokhtar E, Fourcade J, Mourali S, Hobeika R, Carrie D, et al. Does stent design affect the long-term outcome after coronary stenting? Catheter Cardiovasc Interv. 2002; 56(3): 305-11.
Fishman RF, Kuntz RE, Carrozza JP, Miller MJ, Senerchia CC, Schnitt SJ, et al. Long-term results of directional coronary atherectomy: predictors of restenosis. J Am Coll Cardiol. 1992; 20(5): 1101-10.
Dangas G, Mehran R, Lansky AJ, Waksman R, Satler LF, Pichard AD, et al. Acute and long-term results of treatment of diffuse in-stent restenosis in aortocoronary saphenous vein grafts. Am J Cardiol. 2000; 86(7): 777-9.
Hong MK, Park SW, Moon DH, Oh SJ, Kim EH, Lee CW, et al. Impact of geographic miss on adjacent coronary artery segments in diffuse in-stent restenosis with beta-radiation therapy: angiographic and intravascular ultrasound analysis. Am Heart J. 2002; 143(2): 327-33.
Macdonald RG, Henderson MA, Hirshfeld JW, Goldberg SH, Bass T, Vetrovec G, et al. Patient-related variables and restenosis after percutaneous transluminal coronary angioplasty—A report from the M-HEART Groupt. Am J Cardiol. 1990; 66(12): 926-31.
Gürlek A, Dağalp Z, Oral D, Ömürlö K, Erol Ç, Akyol T, et al. Restenosis after transluminal coronary angioplasty: a risk factor analysis. J of Card risk. 1995; 2(1): 51-5.
van Domburg RT, Foley DP, de Jaegere PP, de Feyter P, van den Brand M, van der Giessen W, et al. Long term outcome after coronary stent implantation: a 10 year single centre experience of 1000 patients. Heart. 1999; 82 (Suppl 2): II27-34.
Popma JJ, De Cesare NB, Pinkerton CA, Kereiakes DJ, Whitlow P, King SB, 3rd, et al. Quantitative analysis of factors influencing late lumen loss and restenosis after directional coronary atherectomy. Am J Cardiol. 1993; 71(7): 552-7.
Heidland UE, Heintzen MP, Klimek WJ, Michel CJ, Strauer BE. Acute complications and restenosis in women undergoing percutaneous transluminal coronary angioplasty. Is it possible to define sex differences and to determine risk factors? J Cardiovasc Risk. 1998; 5(5-6): 297-302.
Pormoghadas m, Khosravi a, Kia b. Comparing the rate of re-stenosis in patients with ballon angioplasty with and without stent in Isfahan Shahid Chamran Hospital. J Shahrekord Univ Med Sci. 2001; 3(2): 22-30.
Pietersma A, Kofflard M, de Wit LEA, Stijnen T, Koster JF, Serruys PW, et al. Late lumen loss after coronary angioplasty is associated with the activation status of circulating phagocytes before treatment. Circulation. 1995; 91(5): 1320-5.
Kotamäki M, Laustiola K, Syvänne M, Heikkilä J. Influence of continued smoking and some biological risk factors on restenosis after percutaneous transluminal coronary angioplasty. J Intern Med. 1996; 240(5): 293-301.
Taira DA, Seto TB, Ho KK, Krumholz HM, Cutlip DE, Berezin R, et al. Impact of smoking on health-related quality of life after percutaneous coronary revascularization. Circulation. 2000; 102(12): 1369-74.
Schaal C, Chellappan SP. Nicotine-mediated cell proliferation and tumor progression in smoking-related cancers. Mol Cancer Res. 2014; 12(1): 14-23.
Van Belle E, Abolmaali K, Bauters C, McFadden EP, Lablanche J-M, Bertrand ME. Restenosis, late vessel occlusion and left ventricular function six months after balloon angioplasty in diabetic patients. J Am Coll Cardiol. 1999; 34(2): 476-85.
Wong SC, Baim DS, Schatz RA, Teirstein PS, King SB, Curry RC, et al. Immediate results and late outcomes after stent implantation in saphenous vein graft lesions: the multicenter US Palmaz-Schatz stent experience. J Am Coll Cardiol. 1995; 26(3): 704-12.
Kastrati A, Hall D, Schomig A. Long-term outcome after coronary stenting. Curr Control Trials Cardiovasc Med. 2000; 1(1): 48-54.
Lee SG, Lee CW, Hong MK, Park HK, Kim JJ, Park SW, et al. Predictors of diffuse-type in-stent restenosis after coronary stent implantation. Catheter Cardiovasc Interv. 1999; 47(4): 406-9.
Lau KW, Ding ZP, Sigwart U, Lam L. Percutaneous interventional strategies in the treatment of chronic total coronary occlusions. Singapore Med J. 2000; 41(9): 468-70.
Hasani H. Clinical Evaluation of Instent Restenosis in Coronary Artery Disease. Feyz. 2005; 9(1): 40-4.
Violaris AG, Melkert R, Serruys PW. Influence of serum cholesterol and cholesterol subfractions on restenosis after successful coronary angioplasty. A quantitative angiographic analysis of 3336 lesions. Circulation. 1994; 90(5): 2267-79.
Kishi K, Hiasa Y, Tanaka H, Tanimoto M, Kinoshita M, Shinohara A, et al. [The importance of serum lipid level for restenosis following initial successful percutaneous transluminal coronary angioplasty in patients with unstable angina]. J of Cardio. 1996; 28(2): 79-84.
Moreno R, Garcia E, Soriano J, Acosta J, Abeytua M. Long-term outcome of patients with proximal left anterior descending coronary artery in-stent restenosis treated with rotational atherectomy. Catheter Cardiovasc Interv. 2001; 52(4): 435-42.
Guardado JH, Moreno R, Costa J, Perez-Viscayno MJ, Segura L, Alfonso F, et al. Proximal left anterior descending coronary artery revascularization with drug-eluting stents. Arq Bras Cardiol. 2007; 88(2): 159-66.
Park CB, Park HK. Predictors of diffuse-type in-stent restenosis following drug-eluting stent implantation. Exp Ther Med. 2013; 5(5): 1486-90.
Storger H. Diffuse in-stent restenosis. J Interv Cardiol. 2001; 14(6): 587-96.
Dietz U, Rupprecht HJ, de Belder MA, Wijns W, Quarles van Ufford MA, Klues HG, et al. Angiographic analysis of the angioplasty versus rotational atherectomy for the treatment of diffuse in-stent restenosis trial (ARTIST). Am J Cardiol. 2002; 90(8): 843-7.
Dietz U, Holz N, Dauer C, Lambertz H. Shortening the stent length reduces restenosis with bare metal stents: matched pair comparison of short stenting and conventional stenting. Heart. 2006; 92(1): 80-4.
Schillinger M, Exner M, Mlekusch W, Rumpold H, Ahmadi R, Sabeti S, et al. Vascular Inflammation and Percutaneous Transluminal Angioplasty of the Femoropopliteal Artery: Association with Restenosis. Radiology. 2002; 225(1): 21-6.
Gottsauner-Wolf M, Zasmeta G, Hornykewycz S, Nikfardjam M, Stepan E, Wexberg P, et al. Plasma levels of C-reactive protein after coronary stent implantation. Euro Heart J. 2000; 21(14): 1152-8.
Zurakowski A, Wojakowski W, Dzielski T, Milewski K, Gościńska-Bis K, Tendera M, et al. Plasma levels of C-reactive protein and interleukin-10 predict late coronary in-stent restenosis 6 months after elective stenting. Kardiologia Polska. 2009; 67(6): 623-30.
Ryu SY, Lee YS, Park J, Kang MG, Kim KS. Relations of plasma high-sensitivity C-reactive protein to various cardiovascular risk factors. J of Korea Med Sci. 2005; 20(3): 379-83.
Gomma A, Hirschfield G, Gallimore J, Lowe G, Pepys M, Fox K. Preprocedural inflammatory markers do not predict restenosis after successful coronary stenting. Am Heart J. 2004; 147(6): 1071-7.
Dibra A, Mehilli J, Braun S, Hadamitzky M, Baum H, Dirschinger J, et al. Association between C-reactive protein levels and subsequent cardiac events among patients with stable angina treated with coronary artery stenting. Am Heart J. 2003; 114(9): 715-22.
Yamaji K, Kimura T, Morimoto T, Nakagawa Y, Inoue K, Soga Y, et al. Very long-term (15 to 20 years) clinical and angiographic outcome after coronary bare metal stent implantation. Circ Cardiovasc Interv. 2010; 3(5): 468-75.
Phan TG, Beare RJ, Jolley D, Das G, Ren M, Wong K, et al. Carotid artery anatomy and geometry as risk factors for carotid atherosclerotic disease. Stroke. 2012; 43(6): 1596-601.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).