TY - JOUR
T1 - Comparison of Outcome After Percutaneous Coronary Intervention for De Novo and In-Stent Restenosis Indications
AU - Jakobsen, Lars
AU - Christiansen, Evald H.
AU - Freeman, Phillip
AU - Kahlert, Johnny
AU - Veien, Karsten
AU - Maeng, Michael
AU - Ellert, Julia
AU - Kristensen, Steen D.
AU - Christensen, Martin K.
AU - Terkelsen, Christian J
AU - Thim, Troels
AU - Lassen, Jens Flensted
AU - Hougaard, Mikkel
AU - Eftekhari, Ashkan
AU - Jensen, Rebekka V.
AU - Støttrup, Nicolaj B
AU - Rasmussen, Jeppe G.
AU - Junker, Anders
AU - Jensen, Lisette O.
N1 - Copyright © 2024. Published by Elsevier Inc.
PY - 2025/1/15
Y1 - 2025/1/15
N2 - In-stent restenosis (ISR) still occurs after percutaneous coronary intervention (PCI). Few studies have compared the outcomes of PCI for de novo stenosis with those of PCI for ISR, and the results are conflicting. The present study aimed to conduct this comparison. Using patient-level data from the randomized all-comer SORT OUT studies III to X, we included all patients with previous PCI and either an ISR or a de novo lesion as the study target lesion. Outcomes of interest were major adverse cardiac events (MACE) and target lesion revascularization (TLR) after 5 years. Of the 2,928 patients with a previous PCI included in the SORT OUT studies, 491 (17%) were treated for ISR and 2,437 (83%) for a de novo stenosis. Baseline characteristics did not differ significantly. At 5 years, MACE occurred in 148 patients (32%) in the ISR group and 654 patients (28%) in the de novo stenosis group (crude and adjusted hazard ratio 1.16 [95% confidence interval (CI) 0.97 to 1.38] and 1.16 [95% CI 0.97 to 1.38]). The risk of TLR was higher in the ISR group compared with the de novo stenosis group (crude and adjusted hazard ratio 1.64 [95% CI 1.24 to 2.17] and 1.71 [95% CI 1.27 to 2.30]). In conclusion, the risk of MACE was similar between PCI for ISR and PCI for de novo lesions after 5 years. However, the risk of TLR was higher in the ISR group compared with the de novo stenosis group.
AB - In-stent restenosis (ISR) still occurs after percutaneous coronary intervention (PCI). Few studies have compared the outcomes of PCI for de novo stenosis with those of PCI for ISR, and the results are conflicting. The present study aimed to conduct this comparison. Using patient-level data from the randomized all-comer SORT OUT studies III to X, we included all patients with previous PCI and either an ISR or a de novo lesion as the study target lesion. Outcomes of interest were major adverse cardiac events (MACE) and target lesion revascularization (TLR) after 5 years. Of the 2,928 patients with a previous PCI included in the SORT OUT studies, 491 (17%) were treated for ISR and 2,437 (83%) for a de novo stenosis. Baseline characteristics did not differ significantly. At 5 years, MACE occurred in 148 patients (32%) in the ISR group and 654 patients (28%) in the de novo stenosis group (crude and adjusted hazard ratio 1.16 [95% confidence interval (CI) 0.97 to 1.38] and 1.16 [95% CI 0.97 to 1.38]). The risk of TLR was higher in the ISR group compared with the de novo stenosis group (crude and adjusted hazard ratio 1.64 [95% CI 1.24 to 2.17] and 1.71 [95% CI 1.27 to 2.30]). In conclusion, the risk of MACE was similar between PCI for ISR and PCI for de novo lesions after 5 years. However, the risk of TLR was higher in the ISR group compared with the de novo stenosis group.
KW - in-stent restenosis
KW - major adverse cardiac events
KW - percutaneous coronary intervention
KW - target lesion revascularization
UR - http://www.scopus.com/inward/record.url?scp=85208463684&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2024.10.019
DO - 10.1016/j.amjcard.2024.10.019
M3 - Journal article
C2 - 39461401
SN - 0002-9149
VL - 235
SP - 1
EP - 8
JO - The American Journal of Cardiology
JF - The American Journal of Cardiology
ER -