Predictors of Diffuse In-Stent Restenosis, a Retrospective Analysis in a Subset of Egyptian Population

Background: Despite the fact that DES implantation has decreased theincidence of ISR dramatically, it is not negligible. Diffuse ISR is associated withpoor outcomes. Most of the data regarding ISR are obtained from studiesincluding BMS stents. Methods: A total of 263 ISR patients were treated at...

Full description

Bibliographic Details
Main Authors: Ahmed Mahmoud El Amrawy, Mohamed Ibrahim Loutfi, Ahmed Mokhtar Abd El Azeem
Format: Article
Language:English
Published: Indonesian Heart Association 2025-01-01
Series:Majalah Kardiologi Indonesia
Subjects:
Online Access:https://ijconline.id/index.php/ijc/article/view/1656
_version_ 1826907351902322688
author Ahmed Mahmoud El Amrawy
Mohamed Ibrahim Loutfi
Ahmed Mokhtar Abd El Azeem
author_facet Ahmed Mahmoud El Amrawy
Mohamed Ibrahim Loutfi
Ahmed Mokhtar Abd El Azeem
author_sort Ahmed Mahmoud El Amrawy
collection DOAJ
description Background: Despite the fact that DES implantation has decreased theincidence of ISR dramatically, it is not negligible. Diffuse ISR is associated withpoor outcomes. Most of the data regarding ISR are obtained from studiesincluding BMS stents. Methods: A total of 263 ISR patients were treated at two tertiary carehospitals from September 2017 through December 2022. 40 patients wereexcluded because the previous angiography and procedure details were notavailable, IVUS data were available for only 30 patients and the patients werenot included in the analysis, so only 193 ISR patients were included in theanalysis. We compared different clinical and procedural risk factors betweendiffuse and focal patterns of ISR following DES implantations. Results: A total of 193 ISR lesions were included in the analysis, distributedas 53.4% diffuse pattern and 46.6% focal pattern. In the multivariate analysis,only increased stent length [OR 1.270 (1.157 – 1.394) 95%CI, P<0.001],lower LVEF [OR 0.903, (0.860 – 0.949) 95%CI, P<0.001], occurrence ofprocedural complications [OR 15.584 (2.075 – 117.044) 95%CI, P=0.008],smoking [OR 3.182, (1.071 – 9.451) 95%CI, P=0.037] and older age [OR1.086, (1.014 – 1.163) 95%CI, P=0.019] were independent risk factors ofdiffuse ISR. DM was not associated with diffuse ISR in the multivariate analysis. Conclusions: Increased age, smoking, reduced left ventricular ejectionfraction, occurrence of procedural complications and increased stent lengthare independent predictors of diffuse ISR. Diabetes mellitus was not found tobe independently associated with a diffuse pattern of ISR.
first_indexed 2025-02-17T09:05:01Z
format Article
id doaj.art-99b032be0e1747e9964d2379200f5d3a
institution Directory Open Access Journal
issn 0126-3773
2620-4762
language English
last_indexed 2025-02-17T09:05:01Z
publishDate 2025-01-01
publisher Indonesian Heart Association
record_format Article
series Majalah Kardiologi Indonesia
spelling doaj.art-99b032be0e1747e9964d2379200f5d3a2025-01-02T16:36:42ZengIndonesian Heart AssociationMajalah Kardiologi Indonesia0126-37732620-47622025-01-0145110.30701/ijc.1656Predictors of Diffuse In-Stent Restenosis, a Retrospective Analysis in a Subset of Egyptian PopulationAhmed Mahmoud El Amrawy0Mohamed Ibrahim Loutfi1Ahmed Mokhtar Abd El Azeem2Cardiology Department, Faculty of Medicine, Alexandria University, EgyptCardiology Department, Faculty of Medicine, Alexandria University, EgyptCardiology Department, Faculty of Medicine, Alexandria University, Egypt Background: Despite the fact that DES implantation has decreased theincidence of ISR dramatically, it is not negligible. Diffuse ISR is associated withpoor outcomes. Most of the data regarding ISR are obtained from studiesincluding BMS stents. Methods: A total of 263 ISR patients were treated at two tertiary carehospitals from September 2017 through December 2022. 40 patients wereexcluded because the previous angiography and procedure details were notavailable, IVUS data were available for only 30 patients and the patients werenot included in the analysis, so only 193 ISR patients were included in theanalysis. We compared different clinical and procedural risk factors betweendiffuse and focal patterns of ISR following DES implantations. Results: A total of 193 ISR lesions were included in the analysis, distributedas 53.4% diffuse pattern and 46.6% focal pattern. In the multivariate analysis,only increased stent length [OR 1.270 (1.157 – 1.394) 95%CI, P<0.001],lower LVEF [OR 0.903, (0.860 – 0.949) 95%CI, P<0.001], occurrence ofprocedural complications [OR 15.584 (2.075 – 117.044) 95%CI, P=0.008],smoking [OR 3.182, (1.071 – 9.451) 95%CI, P=0.037] and older age [OR1.086, (1.014 – 1.163) 95%CI, P=0.019] were independent risk factors ofdiffuse ISR. DM was not associated with diffuse ISR in the multivariate analysis. Conclusions: Increased age, smoking, reduced left ventricular ejectionfraction, occurrence of procedural complications and increased stent lengthare independent predictors of diffuse ISR. Diabetes mellitus was not found tobe independently associated with a diffuse pattern of ISR. https://ijconline.id/index.php/ijc/article/view/1656Diffuse in-stent restenosis, stent length, predictors of in-stent restenosis
spellingShingle Ahmed Mahmoud El Amrawy
Mohamed Ibrahim Loutfi
Ahmed Mokhtar Abd El Azeem
Predictors of Diffuse In-Stent Restenosis, a Retrospective Analysis in a Subset of Egyptian Population
Majalah Kardiologi Indonesia
Diffuse in-stent restenosis, stent length, predictors of in-stent restenosis
title Predictors of Diffuse In-Stent Restenosis, a Retrospective Analysis in a Subset of Egyptian Population
title_full Predictors of Diffuse In-Stent Restenosis, a Retrospective Analysis in a Subset of Egyptian Population
title_fullStr Predictors of Diffuse In-Stent Restenosis, a Retrospective Analysis in a Subset of Egyptian Population
title_full_unstemmed Predictors of Diffuse In-Stent Restenosis, a Retrospective Analysis in a Subset of Egyptian Population
title_short Predictors of Diffuse In-Stent Restenosis, a Retrospective Analysis in a Subset of Egyptian Population
title_sort predictors of diffuse in stent restenosis a retrospective analysis in a subset of egyptian population
topic Diffuse in-stent restenosis, stent length, predictors of in-stent restenosis
url https://ijconline.id/index.php/ijc/article/view/1656
work_keys_str_mv AT ahmedmahmoudelamrawy predictorsofdiffuseinstentrestenosisaretrospectiveanalysisinasubsetofegyptianpopulation
AT mohamedibrahimloutfi predictorsofdiffuseinstentrestenosisaretrospectiveanalysisinasubsetofegyptianpopulation
AT ahmedmokhtarabdelazeem predictorsofdiffuseinstentrestenosisaretrospectiveanalysisinasubsetofegyptianpopulation