ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Long-term outcomes after percutaneous coronary intervention of in-stent restenosis in patients presenting with acute and chronic coronary syndrome.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundLimited data are available on long-term outcomes after percutaneous coronary intervention (PCI) of coronary drug-eluting stent (DES) in-stent restenosis (ISR) depending on clinical presentation with acute coronary syndrome (ACS) or chronic coronary syndrome (CCS).
aimsThus, the aim of this observational, retrospective study was to address this lack of evidence.
methodsBetween January 2007 and February 2021, a total of 3,511 patients with 5,497 ISR lesions were treated at 2 large-volume centers in Munich, Germany, of which 1,029 (29.3%) were treated for ACS. Endpoints of interest were the rates of cardiac death, myocardial infarction (MI), repeat revascularization, and stent thrombosis (ST). Survival was analyzed using the Kaplan-Meier method. Differences between the groups were tested with the log-rank test. Conventional multivariable analysis with adjustment for relevant variables was performed.
resultsAfter ten years, the rates of cardiac death were 42.5% in patients with ACS and 33.3% in patients with CCS (HR 1.63 [95% CI, 1.41-1.88], p < 0.001). 17.4% of ACS patients and 9.5% of CCS patients experienced MI (HR 2.04 [95% CI, 1.65-2.50], p < 0.001). The rates of ST were 3.6% in patients with ACS and 1.2% in patients with CCS (HR 3.18 [95% CI, 1.92-5.24], p < 0.001). The rates of repeat revascularization of target lesion, target vessel and non-target vessel did not differ significantly between both groups in the long-term.
conclusionsIn the long-term, the rates of cardiac death, MI and ST after PCI of DES-ISR are significantly higher in ACS patients than in CCS patients.
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