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Is coronary artery tortuosity a predisposing factor for drug-eluting stent restenosis?

Fatih Levent1,2, Oktay Senoz3, Sadık Volkan Emren4

  • 1Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey. fatihlevent85@hotmail.com.

Herz
|April 25, 2021
PubMed

Insights

Coronary artery tortuosity (CAT) is a significant predictor of in-stent restenosis after drug-eluting stent implantation. Higher CAT severity correlates with increased restenosis risk in patients with stable or unstable angina.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Coronary artery tortuosity (CAT) is a common finding but its clinical significance is not fully understood.
  • CAT may be linked to impaired left ventricular function and coronary ischemia.
  • The predictive value of CAT for stent restenosis remains unknown.

Purpose of the Study:

  • To determine if the severity of coronary artery tortuosity predicts in-stent restenosis.
  • To investigate the association between CAT and outcomes after drug-eluting stent implantation.

Main Methods:

  • A cohort of 637 patients undergoing drug-eluting stent implantation for angina were analyzed.
  • Patients were divided into groups with (n=312) and without (n=325) in-stent restenosis.
  • Computed tomography (CT) coronary angiography was used to calculate CAT severity using specialized software.

Main Results:

  • Patients with in-stent restenosis exhibited significantly higher CAT than those without (1.25 ± 0.11 vs. 1.11 ± 0.07, p < 0.001).
  • Multivariate analysis identified tortuosity index (HR: 1.246) and circumflex lesion (HR: 1.437) as independent predictors of restenosis.
  • A tortuosity threshold of 1.15 demonstrated 81% sensitivity and 80% specificity for predicting restenosis.

Conclusions:

  • The severity of coronary artery tortuosity is directly proportional to the risk of in-stent stenosis.
  • CAT is an independent predictor of in-stent restenosis in patients with angina undergoing stent implantation.
  • These findings highlight the clinical importance of assessing CAT in interventional cardiology.
Abstract

Keywords:
Angina, unstableCoronary angiographyCoronary artery diseaseCoronary restenosisDrug-eluting stents

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