Previous studies focused on the risk factors of in-stent restenosis (ISR) among general Coronary Artery Disease (CAD) patients who are receiving?percutaneous coronary intervention (PCI)?but risk factors of in-stent restenosis (ISR) among CAD patients with Syphilis after PCI were not fully understood.
A retrospective study was conducted to evaluate the prevalence, risk factors, and attributable risk percentage (PAR%) among CAD patients with Syphilis undergoing PCI for ISR at Beijing Ditan Hospital. 114 CAD patients with Syphilis who have undergone PCI from August 2010 to August 2019 and who received a diagnosis as coronary angiography, PCI, with a periodical follow-up were included in the study.
The imaging, clinical and laboratory, data were reviewed from electronic medical records (EMR). For data analysis, chi-square or Fisher exact test were used.
ISR occurred in 18 patients (15.78%) among 114 CAD patients with syphilis who have undergone PCI. The average stent length was ≥ 35 mm (adjusted hazard ratio [HR] = 4.47, 95% confidence interval [CI] = 1.30-15.44, p = 0.018) according to multivariate Cox regression model. Titres of toluidine red unheated serum test (TRUST) > 1:16 (adjusted HR = 3.72, 95% CI = 1.22-11.36, p = 0.021) increased risk of ISR. Protective predictor of ISR among these patients was successful antisyphilitic treatment (adjusted HR = 0.12, 95% CI = 0.02-0.95, p = 0.045). The values of PAR% for a particular risk factor associated with ISR including titres of TRUST > 1:16, successful antisyphilitic treatment were 12.2%, 24.0%, and -39.6%, and average stent length ≥ 35 mm, respectively, among the patients.
The researchers of the study conclude that clinical intervention is required for preventing the occurrence of ISR among CAD patients with Syphilis undergoing PCI. The results of their study indicated that evaluating the length of the stent (< 35 mm), providing antisyphilitic treatment and prioritising the clinical intervention for titres of TRUST (> 1:16) could reduce the risk of ISR.