REPEATED CORONARY EVENTS ON THE BACKGROUND OF CORONARY ARTERY STENT RESTENOSIS

The purpose of the study was to investigate the incidence of in-stent restenosis after the first percutaneous coronary intervention (PCI) in patients with recurrent coronary event and to evaluate the influence of comorbidity factor. The analysis of 1,198 electronic patient histories from the Department of Emergency Cardiology with Anesthesiology-Resuscitation Group (ECA with ARG) of the Republic’s Vascular Center, “Republic’s Hospital No. 2 – Сenter Of Emergency Medical Aid», for the year 2022 was carried out. According to the results of the analysis, 77.5 % of 1,198 patients of the Department were treated for acute coronary syndrome (ACS), out of which 62 % were diagnosed with myocardial infarction. The ACS patients underwent PCI in 78.5 % of cases. Restenosis of the previously implanted stent within 5 years was detected in 2.7 % of patients with ACS. Patients with stent restenosis were predominantly men (84 %) aged 60 – 74 years (76 %). Among the studied 60-74-year-old patients, in 68.4 % of the cases, repeated hospitalizations were related to stent restenosis in one year or more after PCI. Recurrent coronary events in 36 % of patients were manifested as ST-segment elevation myocardial infarction (STEMI); 24 % experienced non-ST-segment elevation myocardial infarction (NSTEMI); and 40 % of the patients with stent restenosis were diagnosed with unstable angina. Drug-eluting stents were used in 84 % of the cases undergoing PCI; 56 % of the patients received PCI with two or more stents. Multivessel coronary artery lesions occurred in 80 % of the patients. All patients with restenosis had arterial hypertension, 20 % were obese (BMI≥30 kg/m2), 16 % had type 2 diabetes mellitus, and 4 % had impaired glucose tolerance. Target cholesterol LDL levels were not achieved in 72 % of the patients. According to transthoracic echocardiography data, 28 % of the patients with stent restenosis had left ventricular ejection fraction less than 40 % according to Simpson. Among the comorbidities, chronic obstructive pulmonary disease was found in every third (32 %) patient; chronic kidney disease was seen in 40 %.

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