{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T17:01:44Z","timestamp":1785171704199,"version":"3.55.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Clinical presentation of bare metal stent in-stent restenosis (ISR) in patients undergoing target lesion revascularization is well characterized and negatively affects on outcomes, whereas the presentation and outcomes of first- and second-generation drug-eluting stents (DESs) remains under-reported.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              The study included 909 patients (1077 ISR lesions) distributed as follows: bare metal stent (n=388), first-generation DES (n=425), and second-generation DES (n=96), categorized into acute coronary syndrome (ACS) or non-ACS presentation mode at the time of first target lesion revascularization. ACS was further classified as myocardial infarction (MI) and unstable angina. For bare metal stent, first-generation DES and second-generation DES, ACS was the clinical presentation in 67.8%, 71.0%, and 66.7% of patients, respectively (\n              <jats:italic>P<\/jats:italic>\n              =0.470), whereas MI occurred in 10.6%, 10.1%, and 5.2% of patients, respectively (\n              <jats:italic>P<\/jats:italic>\n              =0.273). The correlates for MI as ISR presentation were current smokers (odds ratio, 3.02; 95% confidence interval [CI], 1.78\u20135.13;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and chronic renal failure (odds ratio, 2.73; 95% CI, 1.60\u20134.70;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), with a protective trend for the second-generation DES ISR (odds ratio, 0.35; 95% CI, 0.12\u20131.03;\n              <jats:italic>P<\/jats:italic>\n              =0.060). ACS presentations had an independent effect on major adverse cardiac events (death, MI, and re-target lesion revascularization) at 6 months (MI versus non-ACS: adjusted hazard ratio, 4.06; 95% CI, 1.84\u20138.94;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; unstable angina versus non-ACS: adjusted hazard ratio, 1.98; 95% CI, 1.01\u20133.87;\n              <jats:italic>P<\/jats:italic>\n              =0.046).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>ISR clinical presentation is similar irrespective of stent type. MI as ISR presentation seems to be associated with patient and not device-related factors. ACS as ISR presentation has an independent effect on major adverse cardiac events, suggesting that ISR remains a hazard and should be minimized.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.114.001341","type":"journal-article","created":{"date-parts":[[2014,12,3]],"date-time":"2014-12-03T03:28:40Z","timestamp":1417577320000},"page":"768-776","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":66,"title":["Clinical Presentation and Outcomes of Coronary In-Stent Restenosis Across 3-Stent Generations"],"prefix":"10.1161","volume":"7","author":[{"given":"Marco A.","family":"Magalhaes","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sa\u2019ar","family":"Minha","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Chen","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Torguson","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Al Fazir","family":"Omar","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua P.","family":"Loh","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo O.","family":"Escarcega","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Lipinski","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nevin C.","family":"Baker","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironori","family":"Kitabata","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Ota","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William O.","family":"Suddath","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lowell F.","family":"Satler","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto D.","family":"Pichard","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Waksman","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine, MedStar Washington Hospital Center, DC."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circinterventions.111.967802"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2005.08.011"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2007.06.024"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.70.1026"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.04.007"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa035071"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032441"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl229"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.01.011"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/circinterventions.112.000248"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.113.001790"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.707331"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24398"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV5I7A141"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV9I5A92"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.110.988436"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV6I3A63"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.100.18.1872"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/circimaging.112.976167"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/hc3201.094225"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1159\/000353097"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2013.03.046"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV8I5A91"},{"key":"e_1_3_2_25_2","first-page":"266","article-title":"Target 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Target lesion revascularization after bare-metal or drug-eluting stents: clinical presentations and outcomes. 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