The incidence of percutaneous coronary intervention (PCI) in Europe has been increasing in recent years. But little was known about the characteristics of interventional treatment of in-stent-re-stenosis (ISR) in clinical practice in Europe.
Anselm K. Gitt, MD, of Herzzentrum Ludwigshafen, Universitat Heidelberg, Ludwigshafen, Germany, chairman of the Euro Heart Survey Programme of the European Society of Cardiology, and colleagues examined the differences between treatment of ISR vs de novo-lesions in patients undergoing PCI for acute coronary syndrome (ACS) in clinical practice. Between 2005 and 2008, 47,407 consecutive patients undergoing PCI were enrolled in the Programme’s PCI Registry.
Of the total of 14,011 patients who underwent PCI for ACS, in 789 (5.6%) the culprit lesion treated was an ISR. According to Dr. Gitt and colleagues, patients with ISR more often were male and had diabetes, prior myocardial infarction, and coronary artery bypass than patients undergoing PCI in de-novo lesions. No differences were found in the use of anti-thrombotic drugs despite a more frequent use of GP IIb/IIIa receptor blockers (even in patients with de-novo lesions rather than ISR).
In ISR, 70.1% of patients received a stent (64.6% of them DES). The rate of stenting in de-novo lesions was 94.8% (38.0% of them DES). There were no observed differences in hospital outcome.