Predictive factors of in-stent restenosis

Introduction and objective. Stenting has contributed to improve the early a ngiographic result, the restenosis rate and the problem of acute and subacu te coronary occlusion. In spite of this, the restenosis phenomenon still re mains a problem to be completely solved. The aim of the study was to identi fy clinical, angiographical and procedural factors that are predictive of i n-stent restenosis after succesful implantation of coronary stent. Material and methods. We retrospectively analyzed 202 lesions, in 176 conse cutive patients who underwent stent implantation with success;in our hospit al between January 1995 and August 1998. All patients had a clinical follow -up and an angiography after six months of stent implantation. Results. From 202 lesions evaluated, 47 evolved with restenosis (23%). The only independent predictive variables were: to be receiving hypolipemiant t reatment before stenting (OR: 0.3; IC: 0.1-0.8), the use of high pressure f or stent implantation (OR: 0.4; IC: 0.2-0.9), to implant stent in < 3.1 mm (OR: 2.2; IC: 1.1-4.5) and to have a residual stenosis >30% after stenting (OR: 13; IC: 1.5-120). Conclusions. The only statistical variables associated with in-stent resten osis phenomenon were: be under hypolipemiant treatment before the procedure and the use of high pressures for stent implantation; while risk factors a rose: to implant stent in vessels < 3.1 mm and suboptimal angiography resul t after stenting.