Risk of major adverse cardiovascular events with in-stent restenosis of bare metal stents

Bare metal stents (BMS) are frequently used in treating stenotic coronary vessels during percutaneous coronary intervention (PCI). There is risk of developing restenosis within the stent. Our objective was to evaluate the hazard of having major adverse cardiovascular events (MACE) in patients with BMS who are found on repeat angiogram to have in-stent restenosis (ISR) compared to those without ISR. Our study population included 140 patients with previous BMS undergoing repeat coronary angiography for suspected symptomatic BMS ISR. Over half the patients had ISR (n=72, 51.4%). Among 39 patients who had MACE, 30 patients had ISR and 9 patients had patent stents. Patients with ISR had a significantly higher risk of having MACE (HR 4.63, P<0.001, CI 2.07 to 10.38). In conclusion, patients with BMS who present with ISR on repeat angiogram have a significant risk of developing MACE that is much higher than those with patent stents.