Identification Of Risk Factors Influencing In-Stent Restenosis (ISR) In Post Percutaneous Coronary Intervention (PCI) Patients

Abstract

Background: To identify and analyze the risk factors influencing in-stent restenosis (ISR) in patients following percutaneous coronary intervention (PCI).

Methodology: A retrospective cross-sectional study was conducted at the Cardiology Unit of Hayat Abad Medical Complex, Peshawar, from February 2021 to September 2022. The study included 292 patients who had undergone PCI within the last six years and were currently presenting with symptoms of angina or acute coronary syndrome (ACS). Patients were divided into two groups based on coronary angiography findings: ISR Group (n=147) and Non-ISR Group (n=145). Data collection was performed using a pre-designed questionnaire, with subsequent clinical and laboratory examinations to identify potential ISR risk factors. Statistical analysis involved chi-square and t-tests for categorical and continuous variables, respectively, and multivariate logistic regression to adjust for confounders.

Results: Significant risk factors for ISR included diabetes mellitus (P=0.001), smoking (P=0.002), hypertension (P=0.003), and elevated LDL cholesterol levels (P=0.030). Stent-related factors such as longer stent length (>40mm) and smaller diameter (<2.75mm) also showed significant associations with ISR occurrence. The logistic regression analysis confirmed these factors as independent predictors of ISR.

Conclusion: The study highlights the importance of comprehensive risk factor management and careful procedural planning in reducing the incidence of ISR. Targeted interventions focusing on modifiable risk factors and optimizing stent selection and placement are crucial for improving long-term outcomes in patients undergoing PCI.