Mr. Samnang, a Cambodian national, has a medical history of type 2 diabetes, hypertension, dyslipidemia, and grade two fatty liver. He receives medical treatment for these conditions and leads a normal life. He had a coronary artery stent placed 10 years ago. Recently, he visited Tam Anh General Clinic District 7 for a health check-up.

Specialized lipid blood tests revealed his lipoprotein(a) index, a factor promoting atherosclerosis, was 149,92 mg/dL, nearly 5 times the recommended threshold (below 30 mg/dL). His hs-CRP index, which assesses inflammation, was 5,1 mg/dL (normal < 1 mg/dL), and LDL-cholesterol was 2,8 mmol/L.

CT scan results showed diffuse atherosclerosis in his coronary artery system, with the previously stented segment experiencing 70-80% restenosis. The patient also had an atherosclerotic plaque at the origin of the right internal carotid artery, causing nearly 40% stenosis, which increases the risk of cerebral ischemia.

Doctor Thao consults the patient about coronary artery restenosis. *Photo: Tam Anh General Hospital*

According to Doctor Pham Thi Thu Thao, a specialist in General Internal Medicine, this case represents coronary artery restenosis in a patient with type 2 diabetes, hypertension, dyslipidemia, and poorly controlled LDL-cholesterol levels, contrary to recommendations. The target for this patient's LDL-cholesterol is below 1,4 mmol/L, equivalent to less than 55 mg/dL.

Individuals with diabetes can experience nerve damage, leading to atypical or absent warning symptoms of myocardial ischemia, such as chest pain. Many cases are only detected when coronary artery damage is advanced. Without timely treatment, atherosclerotic plaques can rupture, forming blood clots that cause acute myocardial infarction or stroke.

Mr. Samnang received medical treatment. After 4 weeks, his health indicators stabilized, and the team performed coronary artery stent placement. The intervention proceeded smoothly, with no complications recorded.

Doctor Thao states that coronary artery restenosis after stent placement can occur in any patient, with a higher risk in individuals with diabetes, hypertension, and dyslipidemia. To reduce the risk of restenosis, patients must adhere to their prescribed medication regimen, manage their weight, and control underlying conditions. After the intervention, patients should maintain a healthy lifestyle, exercise regularly, eat a balanced diet, quit smoking, and limit alcohol consumption.

Doctors recommend that individuals with risk factors like diabetes and hypertension undergo regular health screenings, even without symptoms. Comprehensive screening, combining specialized tests and advanced imaging techniques, can detect silent lesions early.

Thao Vy

*Patient's name has been changed*