Document Type : Original Article
Authors
1 Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Tehran, Iran
2 Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
3 School of Psychology, Deakin University, Melbourne, Australia
Abstract
Objective: While PCI achieves high procedural success rates, persistent risks such as periprocedural thrombosis, inflammatory cascades, and myocardial hypoperfusion contribute to a bimodal pattern of early and late complications, underscoring gaps in current risk prediction models. This research focuses on identifying the risk factors contributing to recurrent coronary events, particularly stent thrombosis and in-stent restenosis, in patients admitted to the cardiac emergency department.
Methods: A retrospective cohort study was conducted on 204 patients at Shahid Rajaei Hospital to analyze their clinical records, including demographic data, cardiovascular risk factors, and treatment history. Data collection utilized a structured checklist encompassing demographics, cardiovascular risk factors, treatment history, procedural details, and outcomes. Statistical analyses (PRISM version 9.0) included descriptive statistics and multivariable logistic regression to assess predictors of outcomes.
Results: Multivariate logistic regression analysis revealed that for same-artery re-involvement, the duration after first myocardial infarction was significantly associated with increased risk (P < 0.0001, OR = 3.666). Regarding stent thrombosis, multiple factors including duration after myocardial infarction (P < 0.001), not taking Plavix (P = 0.033), MI type (P = 0.001), diabetes mellitus (P = 0.002), cigarette smoking (P = 0.029), and absence of family history (P = 0.03) all demonstrated significant effect. For in-stent restenosis, only the absence of diabetes (P = 0.018, OR = 0.432) was significantly associated with decreased likelihood of this outcome.
Conclusion: The study also emphasizes the importance of early detection, regular follow-ups, and effective management strategies, such as pharmacological intervention and lifestyle changes, to reduce the risk of adverse cardiac outcomes. Additionally, it was found that a prolonged duration since the initial myocardial infarction significantly elevates the risks of same-artery re-occlusion and stent thrombosis.
Keywords
- Percutaneous coronary intervention (PCI)
- Acute coronary syndrome
- Heart disease risk factors
- Angioplasty
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