The following is a summary of “Comparison of outcome after Percutaneous Coronary Intervention for De Novo and In-Stent Restenosis indications,” published in the October 2024 issue of Cardiology by Jakobsen et al.
CardiologyIn-stent restenosis (ISR) remains an issue even after patients undergo percutaneous coronary intervention (PCI). Few studies directly compare PCI outcomes between ISR and de novo stenosis, and their results are inconsistent.
Researchers conducted a retrospective study comparing outcomes for ISR and de novo coronary stenosis following PCI, focusing on major adverse cardiac events (MACE) and target lesion revascularization (TLR) over a 5-year follow-up.
They analyzed patient-level data from the randomized all-comer SORT OUT studies (III-X). Inclusion criteria were patients with prior PCI who had either ISR or de novo lesions as the target site for this study. The primary outcomes assessed MACE and TLR outcomes at 5 years for 2,928 patients, where 491 (17%) received treatment for ISR and 2,437 (83%) for de novo stenosis. Baseline characteristics between the groups were similar.
The results showed that after 5 years, MACE occurred in 148 patients (32%) in the ISR group and 654 patients (28%) in the de novo stenosis group, with both crude and adjusted hazard ratios (HR) of 1.16 (95% CI: 0.97-1.38). The TLR risk was higher in the ISR group than the de novo stenosis group, with crude and adjusted HRs of 1.64 (95% CI: 1.24-2.17) and 1.71 (95% CI: 1.27-2.30), respectively.
Investigators concluded that the 5-year risk of MACE was similar for ISR and de novo lesions following PCI. However, patients with ISR had a higher TLR risk than those with de novo stenosis.
Source: ajconline.org/article/S0002-9149(24)00734-3/fulltext