Long-term outcomes after percutaneous coronary intervention of in-stent restenosis in patients presenting with acute and chronic coronary syndrome.

Authors

Constantin Kuna, Marie Mayer, Christian Bradaric, Tobias Koch, Antonia Presch, Felix Voll, Sebastian Kufner, Tareq Ibrahim, Heribert Schunkert, Karl-Ludwig Laugwitz, Salvatore Cassese, Adnan Kastrati, Jens Wiebe

Published in

Clinical research in cardiology : official journal of the German Cardiac Society. Jul 27, 2026. Epub Jul 27, 2026.

Abstract

Limited data are available on long-term outcomes after percutaneous coronary intervention (PCI) of coronary drug-eluting stent (DES) in-stent restenosis (ISR) depending on clinical presentation with acute coronary syndrome (ACS) or chronic coronary syndrome (CCS).
Thus, the aim of this observational, retrospective study was to address this lack of evidence.
Between January 2007 and February 2021, a total of 3,511 patients with 5,497 ISR lesions were treated at 2 large-volume centers in Munich, Germany, of which 1,029 (29.3%) were treated for ACS. Endpoints of interest were the rates of cardiac death, myocardial infarction (MI), repeat revascularization, and stent thrombosis (ST). Survival was analyzed using the Kaplan-Meier method. Differences between the groups were tested with the log-rank test. Conventional multivariable analysis with adjustment for relevant variables was performed.
After ten years, the rates of cardiac death were 42.5% in patients with ACS and 33.3% in patients with CCS (HR 1.63 [95% CI, 1.41-1.88], p < 0.001). 17.4% of ACS patients and 9.5% of CCS patients experienced MI (HR 2.04 [95% CI, 1.65-2.50], p < 0.001). The rates of ST were 3.6% in patients with ACS and 1.2% in patients with CCS (HR 3.18 [95% CI, 1.92-5.24], p < 0.001). The rates of repeat revascularization of target lesion, target vessel and non-target vessel did not differ significantly between both groups in the long-term.
In the long-term, the rates of cardiac death, MI and ST after PCI of DES-ISR are significantly higher in ACS patients than in CCS patients.

PMID:
42507156
Bibliographic data and abstract were imported from PubMed on 27 Jul 2026.

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