EPIDEMIOLOGICAL ASPECTS OF IN-STENT THROMBOSIS AND RESTENOSIS OF CORONARY ARTERIES IN PATIENTS WITH PREVIOUS REVASCULARIZATION AFTER CORONAVIRUS INFECTION

Abstract

Introduction. Understanding the risk factors for thrombosis and in-stent restenosis is of particular importance for the people at risk for adverse outcomes, especially in older patients with previously revascularized myocardium and comorbid conditions including coronavirus infection. The purpose of the study was to assess the risk factors for restenosis and in-stent thrombosis of the coronary artery in patients with previously revascularized myocardium who had suffered coronavirus infection. Materials and methods. We conducted a retrospective epidemiological study of the prevalence of in-stent thrombosis and restenosis, calculating the odds ratio for each risk factor in a continuous sample of individuals who underwent coronary angiography followed by myocardial revascularization with stenting for the period from May 2020 to May 2023. During the entire study period, 7,738 people underwent coronary angiography, of which 4,619 patients received coronary artery stenting according to indications. Statistical analysis was performed using SPSS version 20.0 software (IBM Ireland Product Distribution Limited, Ireland). To assess the contribution of each risk factor to the development of late postoperative complications, odds ratios were calculated. Results. The presence of diabetes mellitus more than doubles the chances of developing restenosis and coronary artery stent thrombosis; for arterial hypertension, this rate was 1.5. Male gender is associated with a 2.9-fold increased chance of in-stent restenosis. For D-dimer, troponin, ALT, AST, creatinine, C-reactive protein and CPK, the odds of coronary artery restenosis increased more than twice (p<0.001). Age and left ventricular ejection fraction did not play a role in the development of the pathology under study. The maximum increase in the odds of coronary artery restenosis was observed in patients who had coronavirus infection – 3.176 (p <0.001). Conclusion. Maximum efforts should be made to prevent restenosis, taking into account modifiable risk factors and the possibility of an individualized approach to treatment.