ArticleBMC cardiovascular disorders2026
Immune dysregulation complicated by recurrent in-stent restenosis in patients with multivessel coronary artery disease: a case report.
Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe management of complex coronary artery disease (CAD) predominantly relies on percutaneous coronary intervention (PCI), yet in-stent restenosis (ISR) remains a critical long-term complication. Emerging evidence implicates immune dysregulation in ISR pathogenesis. CASE PRESENTATION: We present a 74-year-old female with multivessel CAD, recurrent ISR, and comorbidities including hypertension, type 2 diabetes, and hyperlipidemia. Laboratory studies revealed hypogammaglobulinemia M (IgM: 0.306 g/L), an elevated CD4/CD8 ratio (3.24), and elevated hypogammaglobulinemia G3 (IgG3: 0.963 g/L). Intravascular imaging and PET/CT demonstrated neoatherosclerosis with peristrut inflammation. Despite multiple PCIs and guideline-directed medical therapy (GDMT), she experienced recurrent angina. Following adjunctive anti-inflammatory therapy with prednisone and immunomodulation with mycophenolate mofetil, she achieved symptomatic and angiographic stabilization.
conclusionThis case suggests a potential association between immune dysregulation and recurrent ISR. Anti-inflammatory and immunomodulatory therapy may represent a novel adjunctive strategy in selected refractory cases, though causality remains speculative and requires further validation.
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