Analysis of the causes of repeat stenosis of the coronary arteries after elective stenting in patients with stable angina pectoris

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Abstract

Aim. Coronary stenting is the evidence-based treatment approach of stable angina. The objective was to determine the incidence of restenosis or atherosclerosis progression which led to the need for coronary angiography according to a single center registry data.

Materials and methods. The procedure and clinical data of 3732 (2897 males) consecutive stable coronary artery disease patients undergoing coronary stenting, over five years between March 2010 and September 2014, were subject of this study. Over the next 4 years, 1487 (1173 males) patients were re-evaluated due to angina reoccurrence. 699 patients demonstrated the indications for coronary angiography.

Results. The restenosis of the previously stented segment was detected in 84 (12%) cases, the progression of coronary atherosclerosis – in 306 (44%), the combination of restenosis and atherosclerosis progression in 63 (9%), and the absence of these complications in 245 (35%) cases. The progression of coronary atherosclerosis was the leading indication for the repeat angiography and revascularization (44 and 58%, respectively); p<0.05. The basal level of hsCRP≥2 mg/l had a prognostic significance for the development of combined event (the restenosis and atherosclerosis progression): AUC 0.65 (0.50–0.75), OR 3.0 (1.1–7.9), p<0.05.

Conclusion. The progression of coronary atherosclerosis was the leading indication for the repeat angiography and repeat revascularization during 2 years after coronary stenting. The hsCRP level ≥2 mg/l at baseline had a prognostic significance for the development of restenosis in previously stented segment and coronary atherosclerosis progression.

About the authors

Anastasia Y. Filatova

National Medical Research Center of Cardiology

Author for correspondence.
Email: AYFilatova@cardio.ru
ORCID iD: 0000-0001-8911-1628

мл. науч. сотр. лаб. клеточной иммунологии Института экспериментальной кардиологии ФГБУ «НМИЦ кардиологии»

Russian Federation, 15a, 3rd Cherepkovskaya street, Moscow, 121552

Anna K. Osokina

National Medical Research Center of Cardiology

Email: AYFilatova@cardio.ru
ORCID iD: 0000-0001-8127-4609

аспирант отд. легочной гипертензии и заболеваний сердца Института клинической кардиологии им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, 15a, 3rd Cherepkovskaya street, Moscow, 121552

Alexandra V. Potekhina

National Medical Research Center of Cardiology

Email: AYFilatova@cardio.ru
ORCID iD: 0000-0001-9290-9884

к.м.н., науч. сотр. отд. легочной гипертензии и заболеваний сердца Института клинической кардиологии им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, 15a, 3rd Cherepkovskaya street, Moscow, 121552

Ivan V. Romasov

National Medical Research Center of Cardiology

Email: AYFilatova@cardio.ru
ORCID iD: 0000-0002-9918-9995

аспирант отд. рентгенэндоваскулярных методов диагностики и лечения Института клинической кардиологии им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, 15a, 3rd Cherepkovskaya street, Moscow, 121552

Tatiana I. Kotkina

National Medical Research Center of Cardiology

Email: AYFilatova@cardio.ru
ORCID iD: 0000-0002-5483-7143

к.м.н., врач клинической лабораторной диагностики отд-ния клинической лабораторной диагностики Института клинической кардиологии им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, 15a, 3rd Cherepkovskaya street, Moscow, 121552

Alexandra M. Shchinova

National Medical Research Center of Cardiology

Email: AYFilatova@cardio.ru
ORCID iD: 0000-0002-3631-5026

аспирант отд. легочной гипертензии и заболеваний сердца Института клинической кардиологии им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, 15a, 3rd Cherepkovskaya street, Moscow, 121552

Elena A. Noeva

National Medical Research Center of Cardiology

Email: AYFilatova@cardio.ru
ORCID iD: 0000-0003-3147-8050

к.м.н., ст. науч. сотр. отд. легочной гипертензии и заболеваний сердца Института клинической кардиологии им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, 15a, 3rd Cherepkovskaya street, Moscow, 121552

Tatiana I. Arefieva

National Medical Research Center of Cardiology

Email: AYFilatova@cardio.ru
ORCID iD: 0000-0002-9500-1940

д.б.н., гл. науч. сотр., и.о. зав. лаб. клеточной иммунологии Института экспериментальной кардиологии ФГБУ «НМИЦ кардиологии»

Russian Federation, 15a, 3rd Cherepkovskaya street, Moscow, 121552

Elena A. Barabanova

Sechenov First Moscow State Medical University (Sechenov University)

Email: AYFilatova@cardio.ru
ORCID iD: 0000-0002-2095-8879

доц. каф. общей врачебной практики ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет)

Russian Federation, 8-2, Trubetskaya street, Moscow, 119992

Evgeny V. Merkulov

National Medical Research Center of Cardiology

Email: AYFilatova@cardio.ru
ORCID iD: 0000-0001-8193-8575

д.м.н., ст. науч. сотр., зав. 1-м отд-нием рентгенэндоваскулярных методов диагностики и лечения Института клинической кардиологии им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, 15a, 3rd Cherepkovskaya street, Moscow, 121552

Anatoly N. Samko

National Medical Research Center of Cardiology

Email: AYFilatova@cardio.ru
ORCID iD: 0000-0002-1628-5851

д.м.н., проф., рук. отд. рентгенэндоваскулярных методов диагностики и лечения Института клинической кардиологии им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, 15a, 3rd Cherepkovskaya street, Moscow, 121552

Sergey I. Provatorov

National Medical Research Center of Cardiology

Email: AYFilatova@cardio.ru
ORCID iD: 0000-0002-7936-3634

д.м.н., вед. науч. сотр. отд. легочной гипертензии и заболеваний сердца, отд. рентгенэндоваскулярных методов диагностики и лечения Института клинической кардиологии им. А.Л. Мясникова ФГБУ «НМИЦ кардиологии»

Russian Federation, 15a, 3rd Cherepkovskaya street, Moscow, 121552

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