Zhang L, Wang Y, Zhang Z, et al. - Clinical intervention is needed to prevent in-stent restenosis (ISR) in coronary artery disease (CAD) patients with syphilis receiving percutaneous coronary intervention (PCI). A reduction in risk of ISR occurrence could be achieved by carefully assessing the length of the vessel lesion to ascertain if the stent length is < 35 mm, prioritising the clinical intervention for titres of TRUST(toluidine red unheated serum test) > 1:16, and offering successful antisyphilitic treatment.

• This study included 114 CAD patients with syphilis receiving PCI; ISR occurred in 18 patients (15.78%).

• An elevated risk of ISR was evident in relation to average stent length ≥ 35 mm (adjusted hazard ratio [HR] = 4.47) and titres of the TRUST > 1:16 (adjusted HR = 3.72).

• Protective predictor of ISR was successful antisyphilitic treatment (adjusted HR = 0.12).

• Population attributable risk percentage values of specific risk factors related to ISR including average stent length ≥ 35 mm, titres of TRUST > 1:16, and successful antisyphilitic treatment were estimated to be 12.2%, 24.0%, and -39.6%, respectively.