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Comparison of clinical outcomes between percutaneous coronary intervention for de novo lesions versus in-stent restenosis lesions

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Abstract

In-stent restenosis (ISR) remains the primary concern after a percutaneous coronary intervention (PCI) and is considered to be associated with worse clinical outcomes. However, comparative data on ISR and de novo lesions are rare. Therefore, we aimed to compare PCI-related clinical outcomes between patients with de novo lesions and those with ISR lesions. We undertook a retrospective analysis of patients who had undergone a PCI between 2013 and 2020. The incidences of major adverse cardiac and cerebrovascular events (MACCE) and all-cause death over a 2-year follow-up period were evaluated. In total, 1538 patients were enrolled and divided into two groups: a de novo lesions group (n = 1258, 81.8%) and an ISR lesions group (n = 280, 18.2%). Patients in the ISR lesions group were significantly older, with a higher prevalence of hypertension, diabetes mellitus, dyslipidemia, and chronic kidney disease than those in the de novo lesions group. Kaplan–Meier curves showed no significant between-group differences in the incidence of MACCE (log-rank, p = 0.93) and all-cause death (p = 0.09). After adjustment for other covariates, PCIs for ISR lesions were not found to be significantly associated with MACCE (hazard ratio [HR], 1.10; 95% confidential interval [CI] 0.49–2.49; p = 0.81) and all-cause death (HR, 0.58; 95% CI 0.26–1.31; p = 0.19). PCIs for ISR lesions were not associated with worse clinical outcomes compared with PCIs for de novo lesions.

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Acknowledgements

The authors are grateful to the staff of the Department of Cardiovascular Biology and Medicine at Juntendo University. The authors also appreciate the secretarial assistance of Ms. Yumi Nozawa.

Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Mitsuhiro Takeuchi, Tomotaka Dohi, Tatsuya Fukase, Ryota Nishio, Norihito Takahashi, Hirohisa Endo, Shinichiro Doi, Yoshiteru Kato, Iwao Okai, Hiroshi Iwata, Shinya Okazaki, Kikuo Isoda, Katsumi Miyauchi & Tohru Minamino

  2. Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan

    Tohru Minamino

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  1. Mitsuhiro Takeuchi
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  2. Tomotaka Dohi
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Correspondence to Tomotaka Dohi.

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Takeuchi, M., Dohi, T., Fukase, T. et al. Comparison of clinical outcomes between percutaneous coronary intervention for de novo lesions versus in-stent restenosis lesions. Cardiovasc Interv and Ther 37, 324–332 (2022). https://doi.org/10.1007/s12928-021-00792-5

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  • DOI: https://doi.org/10.1007/s12928-021-00792-5

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