Outcomes of Percutaneous Coronary Intervention for In‐Stent Restenosis Versus De Novo Lesions: A Meta‐Analysis
Background In‐stent restenosis (ISR) is commonly encountered even in the era of contemporary percutaneous coronary intervention (PCI). There is a paucity of data on the comparative outcomes of PCI for ISR lesions versus de novo lesions. Methods and Results An electronic search was conducted for MEDL...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.029300 |
| _version_ | 1797337923093266432 |
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| author | Ayman Elbadawi Alexander T. Dang Ingy Mahana Mohammed Elzeneini Fernando Alonso Subhash Banerjee Dharam J. Kumbhani Islam Y. Elgendy Gary S. Mintz |
| author_facet | Ayman Elbadawi Alexander T. Dang Ingy Mahana Mohammed Elzeneini Fernando Alonso Subhash Banerjee Dharam J. Kumbhani Islam Y. Elgendy Gary S. Mintz |
| author_sort | Ayman Elbadawi |
| collection | DOAJ |
| description | Background In‐stent restenosis (ISR) is commonly encountered even in the era of contemporary percutaneous coronary intervention (PCI). There is a paucity of data on the comparative outcomes of PCI for ISR lesions versus de novo lesions. Methods and Results An electronic search was conducted for MEDLINE, Cochrane, and Embase through August 2022 for studies comparing the clinical outcomes after PCI for ISR versus de novo lesions. The primary outcome was major adverse cardiac events. Data were pooled using a random‐effects model. The final analysis included 12 studies, with a total of 708 391 patients, of whom 71 353 (10.3%) underwent PCI for ISR. The weighted follow‐up duration was 29.1 months. Compared with de novo lesions, PCI for ISR was associated with a higher incidence of major adverse cardiac events (odds ratio [OR], 1.31 [95% CI, 1.18–1.46]). There was no difference on a subgroup analysis of chronic total occlusion lesions versus none (Pinteraction=0.69). PCI for ISR was associated with a higher incidence of all‐cause mortality (OR, 1.03 [95% CI, 1.02–1.04]), myocardial infarction (OR, 1.20 [95% CI, 1.11–1.29]), target vessel revascularization (OR, 1.42 [95% CI, 1.29–1.55]), and stent thrombosis (OR, 1.44 [95% CI, 1.11–1.87]), but no difference in cardiovascular mortality (OR, 1.04 [95% CI, 0.90–1.20]). Conclusions PCI for ISR is associated with higher incidence of adverse cardiac events compared with PCI for de novo lesions. Future efforts should be directed toward prevention of ISR and exploring novel treatment strategies for ISR lesions. |
| first_indexed | 2024-03-08T09:23:36Z |
| format | Article |
| id | doaj.art-febcc27725914d0d8d45fa118492da95 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-08T09:23:36Z |
| publishDate | 2023-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-febcc27725914d0d8d45fa118492da952024-01-31T11:31:17ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-07-01121310.1161/JAHA.122.029300Outcomes of Percutaneous Coronary Intervention for In‐Stent Restenosis Versus De Novo Lesions: A Meta‐AnalysisAyman Elbadawi0Alexander T. Dang1Ingy Mahana2Mohammed Elzeneini3Fernando Alonso4Subhash Banerjee5Dharam J. Kumbhani6Islam Y. Elgendy7Gary S. Mintz8Division of Cardiology University of Texas Southwestern Medical Center Dallas TX USADepartment of Internal Medicine University of Texas Medical Branch Galveston TX USADepartment of Medicine MedStar Georgetown Washington Hospital Center Washington DC USADivision of Cardiology University of Florida Gainesville FL USADepartment of Cardiology, Hospital Universitario de La Princesa, IIS‐IP Universidad Autónoma de Madrid, CIBER‐CV Madrid SpainDivision of Cardiology University of Texas Southwestern Medical Center Dallas TX USADivision of Cardiology University of Texas Southwestern Medical Center Dallas TX USADivision of Cardiovascular Medicine, Gill Heart Institute University of Kentucky Lexington KY USACardiovascular Research Foundation New York NY USABackground In‐stent restenosis (ISR) is commonly encountered even in the era of contemporary percutaneous coronary intervention (PCI). There is a paucity of data on the comparative outcomes of PCI for ISR lesions versus de novo lesions. Methods and Results An electronic search was conducted for MEDLINE, Cochrane, and Embase through August 2022 for studies comparing the clinical outcomes after PCI for ISR versus de novo lesions. The primary outcome was major adverse cardiac events. Data were pooled using a random‐effects model. The final analysis included 12 studies, with a total of 708 391 patients, of whom 71 353 (10.3%) underwent PCI for ISR. The weighted follow‐up duration was 29.1 months. Compared with de novo lesions, PCI for ISR was associated with a higher incidence of major adverse cardiac events (odds ratio [OR], 1.31 [95% CI, 1.18–1.46]). There was no difference on a subgroup analysis of chronic total occlusion lesions versus none (Pinteraction=0.69). PCI for ISR was associated with a higher incidence of all‐cause mortality (OR, 1.03 [95% CI, 1.02–1.04]), myocardial infarction (OR, 1.20 [95% CI, 1.11–1.29]), target vessel revascularization (OR, 1.42 [95% CI, 1.29–1.55]), and stent thrombosis (OR, 1.44 [95% CI, 1.11–1.87]), but no difference in cardiovascular mortality (OR, 1.04 [95% CI, 0.90–1.20]). Conclusions PCI for ISR is associated with higher incidence of adverse cardiac events compared with PCI for de novo lesions. Future efforts should be directed toward prevention of ISR and exploring novel treatment strategies for ISR lesions.https://www.ahajournals.org/doi/10.1161/JAHA.122.029300de novo lesionsin‐stent restenosispercutaneous coronary intervention |
| spellingShingle | Ayman Elbadawi Alexander T. Dang Ingy Mahana Mohammed Elzeneini Fernando Alonso Subhash Banerjee Dharam J. Kumbhani Islam Y. Elgendy Gary S. Mintz Outcomes of Percutaneous Coronary Intervention for In‐Stent Restenosis Versus De Novo Lesions: A Meta‐Analysis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease de novo lesions in‐stent restenosis percutaneous coronary intervention |
| title | Outcomes of Percutaneous Coronary Intervention for In‐Stent Restenosis Versus De Novo Lesions: A Meta‐Analysis |
| title_full | Outcomes of Percutaneous Coronary Intervention for In‐Stent Restenosis Versus De Novo Lesions: A Meta‐Analysis |
| title_fullStr | Outcomes of Percutaneous Coronary Intervention for In‐Stent Restenosis Versus De Novo Lesions: A Meta‐Analysis |
| title_full_unstemmed | Outcomes of Percutaneous Coronary Intervention for In‐Stent Restenosis Versus De Novo Lesions: A Meta‐Analysis |
| title_short | Outcomes of Percutaneous Coronary Intervention for In‐Stent Restenosis Versus De Novo Lesions: A Meta‐Analysis |
| title_sort | outcomes of percutaneous coronary intervention for in stent restenosis versus de novo lesions a meta analysis |
| topic | de novo lesions in‐stent restenosis percutaneous coronary intervention |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.029300 |
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