Wu Yanqiang, Fu Xianghua
Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
J Clin Lab Anal. 2019 Feb;33(2):e22666. doi: 10.1002/jcla.22666. Epub 2018 Sep 17.
This study aimed to explore the correlation of baseline, procedural, and postprocedure characteristics with the risk of rapid angiographic stenotic progression (RASP) and restenosis in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) with drug-eluting stents implantation.
Two hundred fourteen CAD patients underwent PCI with drug-eluting stents implantation were consecutively enrolled. Baseline, procedural, and postprocedure characteristics of patients were collected for analysis. Coronary angiography was performed to evaluate coronary stenosis before PCI and at 12 months after PCI. RASP of nontarget lesions and restenosis of stent-implanted target lesions were then assessed.
37.8% CAD patients occurred RASP at 12 months after PCI and compared to non-RASP group, RASP group presented with increased diabetes mellitus (DM) complication, higher concentration of serum uric acid (SUA), cardiac troponin I, N-terminal probrain natriuretic peptide, and high sensitive C-reactive protein (hs-CRP) as well as elevated occurrence of multivessel artery lesions. In addition, DM, SUA, hs-CRP, and multivessel artery lesions independently predicted high RASP risk. For restenosis, 21.0% patients occurred restenosis at 12 months after PCI, and patients in restenosis group presented with increased hypertension and DM occurrence, higher concentrations of SUA, LDL-C, and hs-CRP, as well as longer target lesion and length of stent in surgery compared to nonrestenosis group. Also, DM, SUA, LDL-C, hs-CRP, and length of target lesion independently predicted increased restenosis risk.
Diabetes mellitus, SUA, and hs-CRP are potential predictive factors for increased risk of both RASP and restenosis in CAD patients underwent PCI and drug-eluting stents implantation.
本研究旨在探讨冠状动脉疾病（CAD）患者在植入药物洗脱支架的经皮冠状动脉介入治疗（PCI）后，基线、手术过程及术后特征与快速血管造影狭窄进展（RASP）风险和再狭窄的相关性。
连续纳入214例行药物洗脱支架植入PCI的CAD患者。收集患者的基线、手术过程及术后特征进行分析。在PCI术前及术后12个月进行冠状动脉造影以评估冠状动脉狭窄情况。然后评估非靶病变的RASP及支架植入靶病变的再狭窄情况。
37.8%的CAD患者在PCI术后12个月发生RASP，与非RASP组相比，RASP组糖尿病（DM）并发症增加、血清尿酸（SUA）、心肌肌钙蛋白I、N末端脑钠肽前体及高敏C反应蛋白（hs-CRP）浓度更高，多支血管病变发生率也更高。此外，DM、SUA、hs-CRP及多支血管病变独立预测高RASP风险。对于再狭窄，21.0%的患者在PCI术后12个月发生再狭窄，与非再狭窄组相比，再狭窄组高血压和DM发生率增加、SUA、低密度脂蛋白胆固醇（LDL-C）及hs-CRP浓度更高，手术中靶病变及支架长度更长。同样，DM、SUA、LDL-C、hs-CRP及靶病变长度独立预测再狭窄风险增加。
糖尿病、SUA及hs-CRP是接受PCI及药物洗脱支架植入的CAD患者RASP和再狭窄风险增加的潜在预测因素。
