Frequency of In-Stent Restenosis (ISR) in Diabetic Patients Following Percutaneous Coronary Intervention (PCI) for Stable Coronary Artery Disease (CAD) with Angina Pectoris Class III

Authors

  • Asad Ullah Khan Peshawar Institute of Cardiology (PIC) Peshawar Pakistan.
  • Fazal Akbar Peshawar Institute of Cardiology MTI Peshawar Pakistan.
  • Shafi Ullah Peshawar Institute of Cardiology MTI Peshawar Pakistan.
  • Hasan Zeb Peshawar Institute of Cardiology MTI Peshawar Pakistan.

DOI:

https://doi.org/10.61919/jhrr.v4i2.909

Keywords:

In-stent restenosis, diabetes mellitus, percutaneous coronary intervention, coronary artery disease, stable ischemic heart disease, angiography, cardiovascular risk management

Abstract

Background: Coronary intervention with stenting is crucial for managing stable ischemic heart disease and acute coronary syndrome, but post-procedural complications such as stent thrombosis and in-stent restenosis (ISR) remain significant challenges. Diabetes mellitus has been identified as a key risk factor contributing to the increased incidence of ISR, thereby complicating long-term outcomes for these patients.

Objective: This study aimed to compare the incidence of ISR between diabetic and non-diabetic patients who have undergone percutaneous coronary intervention (PCI) for stable ischemic heart disease, specifically angina class III.

Methods: A retrospective observational study was conducted at the Peshawar Institute of Cardiology, involving 180 patients who underwent PCI between January and July 2023. Patients were divided into two groups based on the presence or absence of diabetes mellitus (90 in each group). ISR was defined using visual angiography as >50% diameter stenosis within the stent or its adjacent 5mm. The demographic and clinical variables collected included age, gender, BMI, smoking status, hypertension, and family history of coronary artery disease. Statistical analysis was performed using SPSS version 25, employing Chi-square tests for categorical variables, with a significance level set at p < 0.05.

Results: The mean ages of the non-diabetic and diabetic groups were 50.01 ± 8.66 years and 44.26 ± 7.55 years, respectively. The incidence of ISR was significantly higher in the diabetic group (15 out of 90, 16.67%) compared to the non-diabetic group (3 out of 90, 3.33%), with a statistically significant difference (p = 0.001).

Conclusion: Diabetes mellitus significantly increases the risk of in-stent restenosis following PCI in patients with stable ischemic heart disease. This highlights the need for targeted strategies to manage and monitor diabetic patients more aggressively post-PCI to reduce the risk of ISR.

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Author Biographies

Asad Ullah Khan, Peshawar Institute of Cardiology (PIC) Peshawar Pakistan.

Registrar, Department of Cardiology, Peshawar Institute of Cardiology (PIC), Peshawar, Pakistan.

Fazal Akbar, Peshawar Institute of Cardiology MTI Peshawar Pakistan.

Assistant Professor, Department of Cardiology, Peshawar Institute of Cardiology MTI Peshawar, Pakistan.

Shafi Ullah, Peshawar Institute of Cardiology MTI Peshawar Pakistan.

Registrar, Department of Cardiology, Peshawar Institute of Cardiology MTI Peshawar, Pakistan.

Hasan Zeb, Peshawar Institute of Cardiology MTI Peshawar Pakistan.

Post Graduate Resident, Department of Cardiology, Peshawar Institute of Cardiology MTI Peshawar, Pakistan.

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Published

2024-05-08

How to Cite

Khan, A. U., Akbar, F., Ullah, S., & Zeb, H. (2024). Frequency of In-Stent Restenosis (ISR) in Diabetic Patients Following Percutaneous Coronary Intervention (PCI) for Stable Coronary Artery Disease (CAD) with Angina Pectoris Class III. Journal of Health and Rehabilitation Research, 4(2), 567–571. https://doi.org/10.61919/jhrr.v4i2.909