Department of Cardiology, Sultan Abdülhamid Han Training and Research Hospital, Istanbul, Turkey.
Department of Cardiology, SBU Van Training and Research Hospital, Van, Turkey.
Angiology. 2024 Feb;75(2):122-130. doi: 10.1177/00033197221150953. Epub 2023 Jan 6.
Coronary in-stent restenosis (ISR) remains a challenge in interventional cardiology. We investigated the relationship between angiographic pre-interventional grade of lesion stenosis (LS) and the prognosis of late ISR. After exclusions, 110 patients with ISR and 109 patients without ISR were compared. In the ISR group, the grade of LS was greater ( < .001) and the length of the critical segment (LCS) was longer ( < .001). Stent length was longer in the ISR group ( = .008). Compared with the LCS, the grade of LS above 87.5% is 6.9 times more predictive of ISR than the LCS >10.5 mm. Kaplan-Meier curve analysis showed that the grade of initial LS >87.5% had a higher ISR rate than the grade of LS <87.5% (log-rank test < .001) and critical lesion length over 10.5 mm had a higher ISR rate than critical lesion length under 10.5 mm (log-rank test < .001). The present study found that the angiographic pre-interventional grades of LS and LCS were important predictors of ISR. Pre-interventional angiographic stenosis >87.5% was significantly predictive of late ISR.
冠状动脉支架内再狭窄（ISR）仍然是介入心脏病学面临的挑战。我们研究了介入前病变狭窄程度（LS）的血管造影分级与晚期 ISR 预后之间的关系。排除后，比较了 110 例 ISR 患者和 109 例无 ISR 患者。在 ISR 组中，LS 程度更大（ <.001），临界节段长度（LCS）更长（ <.001）。ISR 组的支架长度更长（ =.008）。与 LCS 相比，LS 分级>87.5%比 LCS >10.5 mm 更能预测 ISR，比值比为 6.9。Kaplan-Meier 曲线分析表明，初始 LS 分级>87.5%的 ISR 发生率高于 LS 分级<87.5%（对数秩检验<.001），临界病变长度>10.5 mm 的 ISR 发生率高于临界病变长度<10.5 mm（对数秩检验<.001）。本研究发现，介入前 LS 和 LCS 的血管造影分级是 ISR 的重要预测指标。介入前血管造影狭窄>87.5%与晚期 ISR 显著相关。
