{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:43:26Z","timestamp":1793133806752,"version":"4.5.0"},"reference-count":49,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007700","name":"Carol Davila University of Medicine and Pharmacy","doi-asserted-by":"publisher","award":["Publish not perish"],"award-info":[{"award-number":["Publish not perish"]}],"id":[{"id":"10.13039\/501100007700","id-type":"DOI","asserted-by":"publisher"}]},{"award":["Publish not perish"],"award-info":[{"award-number":["Publish not perish"]}],"id":[{"id":"https:\/\/ror.org\/04fm87419","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Percutaneous coronary intervention (PCI) has markedly improved outcomes in coronary artery disease through the implantation of bare-metal stents (BMS) or drug-eluting stents (DES). However, in-stent restenosis (ISR) remains a significant complication, often necessitating repeat interventions. This study aimed to identify risk factors associated with ISR in patients with ST-elevation myocardial infarction (STEMI) who underwent PCI. Materials and Methods: We conducted a retrospective, non-randomized observational study of 107 STEMI patients treated with PCI between January 2016 and December 2019 who subsequently underwent clinically indicated (predominantly symptom-driven) follow-up coronary angiography within 12 months. ISR was defined as \u226550% luminal narrowing at follow-up angiography. Time-to-event analysis was performed using Cox regression models, incorporating clinical, biochemical, and angiographic variables. Results: In this selected cohort of patients undergoing follow-up angiography, ISR of any degree was identified in 87% of patients, and 52% had restenosis &gt;70%. Advanced age, prior cardiovascular events, diabetes mellitus, chronic kidney disease, and history of stroke significantly increased the hazard of ISR. Smoking, dyslipidemia, and hypertension were prevalent in patients with severe ISR. Women presented with more severe clinical profiles (higher Killip class and troponin levels). DES showed slightly better TIMI flow than BMS, but stent type, dimensions, and number did not significantly impact restenosis risk. Thrombolytic therapy was associated with a significantly reduced ISR hazard. Mortality was 6% in patients with severe ISR. The highest restenosis incidence occurred in the LAD and RCA territories. Conclusions: ISR is a multifactorial process influenced by demographic, clinical, and procedural factors. Despite technological advances, ISR remains a prevalent issue, particularly in high-risk groups undergoing clinically indicated follow-up angiography. Secondary prevention strategies, optimized stent deployment, and targeted therapies addressing inflammation and vascular remodeling are essential to improving long-term PCI outcomes.<\/jats:p>","DOI":"10.3390\/medicina62040785","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T13:22:47Z","timestamp":1776691367000},"page":"785","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Determinants of In-Stent Restenosis in ST-Elevation Myocardial Infarction: Insights from a Single-Center Retrospective Analysis"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6122-7781","authenticated-orcid":false,"given":"Alice Elena","family":"Munteanu","sequence":"first","affiliation":[{"name":"Department of Medical-Surgical and Prophylactical Disciplines, Faculty of Medicine, \u201cTitu Maiorescu\u201d University, 031593 Bucharest, Romania"},{"name":"\u201cCarol Davila\u201d Emergency Hospital, 88 M. Vulcanescu Street, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru Andrei","family":"Badea","sequence":"additional","affiliation":[{"name":"Doctoral School, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silviu Marcel","family":"Stanciu","sequence":"additional","affiliation":[{"name":"\u201cCarol Davila\u201d Emergency Hospital, 88 M. Vulcanescu Street, 010825 Bucharest, Romania"},{"name":"Department No. 5\u2014Internal Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6395-3389","authenticated-orcid":false,"given":"Alexandru Mihai","family":"Popescu","sequence":"additional","affiliation":[{"name":"Doctoral School, Faculty of Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florentina Cristina","family":"Ple\u0219a","sequence":"additional","affiliation":[{"name":"Department No. 6\u2014Clinical Neurosciences, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3355-5048","authenticated-orcid":false,"given":"Ciprian","family":"Constantin","sequence":"additional","affiliation":[{"name":"\u201cCarol Davila\u201d Emergency Hospital, 88 M. Vulcanescu Street, 010825 Bucharest, Romania"},{"name":"Research Metabolism Center, Faculty of Medicine, Titu Maiorescu University, 76 Al I Cuza Blvd, 011053 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"850","DOI":"10.5603\/CJ.a2021.0042","article-title":"Post-percutaneous coronary intervention angina: From physiopathological mechanisms to individualized treatment","volume":"29","author":"Rosano","year":"2022","journal-title":"Cardiol. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2455","DOI":"10.1093\/eurheartj\/ehy857","article-title":"Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary revascularization","volume":"40","author":"Crea","year":"2019","journal-title":"Eur. 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