Impact of COVID-19 on the Risk of Coronary Stent Thrombosis and Restenosis: A Retrospective Angiographic Study

Ygiyeva D. Batenova G. Belikhina T. Orekhov A. Pivin M. Biakhmetova Z. Sadykova L. Zhumagaliyev A. Pivina L.
October 2025 Multidisciplinary Digital Publishing Institute (MDPI)

COVID
2025 #5 Issue 10

Background: The aim of our study is to assess the risk factors for the development of coronary artery stent thrombosis and restenosis, as well as the main localization of these processes in patients who underwent repeated coronary revascularization during the COVID-19 pandemic. Materials and Methods: Data were retrospectively analyzed from 490 patients who underwent coronary angiography and required repeat revascularization from May 2020 to May 2023. The prevalence and anatomical distribution of coronary stenosis, restenosis, and stent thrombosis were assessed. Results: Coronary artery stenosis was detected in 46.9% of patients. The most affected arteries were the left anterior descending (13.7%), right coronary artery (15.1%), and circumflex branch (9.4%). In-stent restenosis was observed in 19.0% of cases. Coronary thrombosis occurred in 22.8% of patients, while stent thrombosis was found in 11.2%. Multivariate regression revealed that leukocyte count (OR = 1.18, p < 0.05), activated partial thromboplastin time (APTP) (OR = 1.021, p = 0.025), low-density lipoproteins (LDL) (OR = 1.421, p = 0.042), and prior COVID-19 infection (OR = 2.05, p = 0.038) were significant predictors of stent thrombosis. The left ventricular ejection fraction (LVEF) (OR = 0.959, p = 0.017) and hemoglobin levels (OR = 0.975, p = 0.014) have inverse association with risk of stent thrombosis. Conclusion: COVID-19 history is a strong independent risk factor for coronary stent thrombosis, alongside inflammatory and coagulation markers.

coronary artery restenosis , COVID-19 , hypercoagulability , myocardial revascularization , neointimal hyperplasia , stent thrombosis , vascular inflammation

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Department of Emergency Medicine, Semey Medical University, Semey, 071400, Kazakhstan
Board for Strategic Development, Scientific and Educational Activities, National Research Oncology Center, Astana, 020000, Kazakhstan
Department of Internal Medicine, Semey Medical University, Semey, 071400, Kazakhstan
Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, Astana, 020017, Kazakhstan

Department of Emergency Medicine
Board for Strategic Development
Department of Internal Medicine
Medical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan

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