THU0138 Occurrence of in-stent restenosis after coronary drug-eluting stent implantation in patients with rheumatoid arthritis

Background Rheumatoid arthritis (RA) is associated with increased risk of cardiovascular events. Thus, patients with RA have a greater chance of undergoing coronary drug-eluting stent (DES) implantation. However, it is not known whether the rate of in-stent restenosis (ISR) is also increased in RA patients. Objectives To investigate characteristics of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation in patients with rheumatoid arthritis (RA), and to evaluate the effect of disease modifying anti-rheumatic drugs (DMARDs) on ISR. Methods Patients with RA who underwent DES implantation between January, 2005 and March, 2017 were included. Characteristics of the patients and the vessel lesions were reviewed retrospectively. To evaluate the effect of DMARDs on ISR, previously known ISR risk factors and ISR incidence were compared between the treated vessels of patients who did and did not receive specific DMARDs. Results In total, 30 RA patients (43 vessel lesions) were included. 4 treated vessel lesions developed ISR (4/43, 9.3%) in median 106.8 (81.1–109.0) months after DES implantation. Compared with the previous data in general population (occurrence of ISR: 3%–20%, mean time of ISR occurrence: 13 months), the incidence was similar, but the time to ISR occurrence was much longer. In the comparison of patients receiving MTX (n=31 vessel lesions) and those not receiving MTX (n=12 vessel lesions), the ISR incidence was significantly different [0/31 (0.0%) vs. 4/12 (33.3%), p=0.004]. Conclusions ISR after DES implantation in RA patients occurs in a similar rate, but after a much longer period of time than in the general population. Administration of MTX in patients with RA might have potential benefit to prevent ISR after DES implantation. Acknowledgements None. Disclosure of Interest None declared