Assessment of the Incidence of In-Stent Restenosis and Its Associated Risk Factors Following Percutaneous Coronary Angioplasty: A Cross-Sectional Study

Background: In-stent restenosis remains a significant concern for cardiologists, as it can lead to recurrent angioplasty, coronary artery bypass surgery, myocardial infarction, or death. This study aimed to evaluate the incidence of in-stent restenosis and associated risk factors following percutaneous coronary angioplasty with drug-eluting stents in patients referred to Shahid Mohammadi Hospital between 2020 and 2022. Methods: This cross-sectional study examined 586 patients with coronary syndrome who underwent coronary angioplasty with stent implantation at Shahid Mohammadi Hospital, Bandar Abbas, Iran, between 2020 and 2022. A researcher-developed checklist was used to collect data on demographic characteristics, clinical findings, and stent-related information from clinical records. Additional data was obtained through telephone interviews with patients as needed. IBM SPSS Statistics software (Version 26) was employed for data analysis, with a significance level below 0.05. The association between coronary restenosis incidence and related factors was evaluated using multivariate logistic regression analysis. Results: Of the 586 patients included in this study, 335 (57.2%) were male, with a mean age of 56.86 +/- 14.61 years. The incidence of in-stent restenosis was 20.8%. Multivariate logistic regression analysis identified several independent risk factors associated with coronary artery restenosis, including hyperlipidemia, diabetes, opium use, a higher number of stents implanted, smaller stent diameter, and increased stent length of intracoronary stents. Conclusions: Recognizing the risk factors for in-stent restenosis can substantially aid healthcare providers in making informed decisions, ultimately leading to improved prevention strategies and overall management for patients with coronary artery disease. A multidisciplinary approach, including addressing modifiable risk factors such as hyperlipidemia, diabetes, and opium use, as well as optimizing stent selection and placement techniques, may contribute to better long-term outcomes for these patients. (Iranian Heart Journal 2024; 25(4): 31-42)