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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Evaluation of relationship between common carotid artery intima-media thickness and coronary in-stent restenosis: A
Penta Bhavanadhar1, Yerrabandi Venkata Subba Reddy2, Adikeshava Naidu Otikunta3
1Department of Cardiology, Maxcure Hospitals, Karimnagar, Telangana, India.
Insights
Elevated common carotid artery intima-media thickness (CIMT) is a significant predictor of coronary in-stent restenosis (ISR). Non-invasive CIMT measurements can help predict restenosis rates in patients post-procedure.
Area of Science:
- Cardiology
- Vascular Ultrasound
- Interventional Cardiology
Background:
- Coronary in-stent restenosis (ISR) remains a clinical challenge after percutaneous coronary intervention (PCI).
- Common carotid artery intima-media thickness (CIMT) is a marker of subclinical atherosclerosis.
- Predictors of ISR require further elucidation for improved patient management.
Purpose of the Study:
- To evaluate the relationship between CIMT and coronary ISR.
- To identify clinical predictors of coronary ISR in PCI-treated patients.
Main Methods:
- A single-center, case-control study conducted in India from December 2012 to February 2015.
- Included PCI-treated patients with ISR (n=32) and without ISR (n=40).
- Quantitative coronary angiography was used to assess ISR, and CIMT was measured.
Main Results:
- Average CIMT was significantly higher in cases (0.96±0.23 mm) compared to controls (0.66±0.09 mm) (p<0.001).
- Hypertension and larger stent diameter were independent predictors of increased ISR.
- Lower CIMT (<0.8 mm), STEMI, and higher estimated glomerular filtration rate were associated with lower ISR.
Conclusions:
- Elevated CIMT is an independent risk indicator for increased coronary ISR.
- Non-invasive CIMT measurements hold potential for predicting restenosis rates in routine clinical practice.
- CIMT assessment may aid in risk stratification and follow-up strategies for patients undergoing PCI.
Aim:
The study was intended to evaluate relationship of common carotid artery intima-media thickness (CIMT) with coronary in-stent restenosis (ISR) and to assess clinical profile of patients to determine the predictors of coronary ISR.
Methods:
This was a single-center, case-control study performed between December 2012 and February 2015 in India. The study population consisted of PCI-treated patients with ISR (n = 32) and those without any post-PCI symptoms at least 6 months prior to the study period (n = 40). Quantitative coronary angiography was performed in patients to determine ISR.
Results:
Average CIMT for cases and controls was 0.96 ± 0.23 and 0.66 ± 0.09 mm (OR = 57, p < 0.001), respectively. CIMT was <0.8 mm in 25% of cases and 95% of controls. On multivariate analysis, presence of hypertension (OR = 10.79, p = 0.026) and higher stent diameter (OR = 14.87, p = 0.039) were independently associated with increased presence of ISR. CIMT <0.8 mm (OR = 0.03, p = 0.025), STEMI (OR = 0.03, p = 0.004), and estimated glomerular filtration rate >50 ml/min (OR = 0.005, p = 0.014) were independently associated with lower presence of ISR.
Conclusions:
Elevated CIMT appears to be an independent risk indicator for increased ISR. As CIMT is a non-invasive parameter, post-PCI follow-up measurements of CIMT in routine clinical practice will provide potential benefits to predict the restenosis rates.
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