Comparison of Outcome After Percutaneous Coronary Intervention for De Novo and In-Stent Restenosis Indications

Lars Jakobsen*, Evald H. Christiansen, Phillip Freeman, Johnny Kahlert, Karsten Veien, Michael Maeng, Julia Ellert, Steen D. Kristensen, Martin K. Christensen, Christian J Terkelsen, Troels Thim, Jens Flensted Lassen, Mikkel Hougaard, Ashkan Eftekhari, Rebekka V. Jensen, Nicolaj B Støttrup, Jeppe G. Rasmussen, Anders Junker, Lisette O. Jensen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

1 Citation (Scopus)

Abstract

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.

Original languageEnglish
JournalThe American Journal of Cardiology
Volume235
Pages (from-to)1-8
Number of pages8
ISSN0002-9149
DOIs
Publication statusPublished - 15 Jan 2025

Bibliographical note

Copyright © 2024. Published by Elsevier Inc.

Keywords

  • in-stent restenosis
  • major adverse cardiac events
  • percutaneous coronary intervention
  • target lesion revascularization

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