Impact of anemia on in-stent restenosis after percutaneous coronary intervention

Abstract Background Anemia is a well-recognized risk factor for adverse events after percutaneous coronary intervention (PCI), but data regarding the association between anemia and in-stent restenosis (ISR) remain limited.Methods A total of 538 patients who underwent PCI between January 2018 and September 2019 and performed follow-up angiography 9–12 months after the initial PCI was enrolled in the study. Baseline clinical and procedural characteristics were compared between ISR and non-ISR group. Multivariate logistic regression analysis was employed to determine the independent predictors of ISR.Results The incidence of anemia in patients with ISR was 53.5% and 19.0% in the non-ISR group, which was significantly different (P ༜0.001). The rate of diabetes, chronic kidney disease (CKD), bifurcation lesion and calcification was significantly higher in ISR group. In addition, low-density lipoprotein cholesterol (LDL-c), multiple stenting and stent diameter were also significantly related with ISR. After multivariate logistic analysis, anemia (odds ratio [OR], 2.786; 95% confidence interval [CI], 1.091 to 7.115; P = 0.032) together with LDL-c (OR, 1.682; 95% CI, 1.145 to 2.469; P = 0.008), diabetes (OR, 3.582; 95% CI, 1.406 to 9.125; P = 0.007), CKD (OR, 2.841; 95% CI, 1.006 to 8.027; P = 0.049), multiple stenting (OR, 2.823; 95% CI, 1.184 to 6.731; P = 0.019), and stent diameter (OR, 2.778; 95% CI, 1.069 to 7.194; P = 0.036) were closely associated with ISR.Conclusion Anemia is closely associated with ISR after PCI, patients with lower hemoglobin have a higher risk of ISR.