Bhavanadhar Penta, Reddy Yerrabandi Venkata Subba, Otikunta Adikeshava Naidu, Srinivas Ravi
Department of Cardiology, Maxcure Hospitals, Karimnagar, Telangana, India.
Department of Cardiology, The Deccan Heart Institute, Hyderabad, Telangana, India.
Interv Med Appl Sci. 2018 Mar;10(1):38-44. doi: 10.1556/1646.10.2018.08.
The study was intended to evaluate relationship of common carotid artery intima-media thickness (CIMT) with coronary in-stent restenosis (ISR) and to assess clinical profile of patients to determine the predictors of coronary ISR.
This was a single-center, case-control study performed between December 2012 and February 2015 in India. The study population consisted of PCI-treated patients with ISR ( = 32) and those without any post-PCI symptoms at least 6 months prior to the study period ( = 40). Quantitative coronary angiography was performed in patients to determine ISR.
Average CIMT for cases and controls was 0.96 ± 0.23 and 0.66 ± 0.09 mm (OR = 57, < 0.001), respectively. CIMT was <0.8 mm in 25% of cases and 95% of controls. On multivariate analysis, presence of hypertension (OR = 10.79, = 0.026) and higher stent diameter (OR = 14.87, = 0.039) were independently associated with increased presence of ISR. CIMT <0.8 mm (OR = 0.03, = 0.025), STEMI (OR = 0.03, = 0.004), and estimated glomerular filtration rate >50 ml/min (OR = 0.005, = 0.014) were independently associated with lower presence of ISR.
Elevated CIMT appears to be an independent risk indicator for increased ISR. As CIMT is a non-invasive parameter, post-PCI follow-up measurements of CIMT in routine clinical practice will provide potential benefits to predict the restenosis rates.
本研究旨在评估颈总动脉内膜中层厚度(CIMT)与冠状动脉支架内再狭窄(ISR)的关系,并评估患者的临床特征以确定冠状动脉ISR的预测因素。
这是一项于2012年12月至2015年2月在印度进行的单中心病例对照研究。研究人群包括经皮冠状动脉介入治疗(PCI)后发生ISR的患者(n = 32)以及在研究期前至少6个月无任何PCI后症状的患者(n = 40)。对患者进行定量冠状动脉造影以确定ISR。
病例组和对照组的平均CIMT分别为0.96±0.23和0.66±0.09毫米(OR = 57,P < 0.001)。25%的病例和95%的对照组CIMT<0.8毫米。多因素分析显示,高血压(OR = 10.79,P = 0.026)和较大的支架直径(OR = 14.87,P = 0.039)与ISR发生率增加独立相关。CIMT<0.8毫米(OR = 0.03,P = 0.025)、ST段抬高型心肌梗死(STEMI,OR = 0.03,P = 0.004)和估计肾小球滤过率>50毫升/分钟(OR = 0.005,P = 0.014)与ISR发生率降低独立相关。
CIMT升高似乎是ISR增加的独立风险指标。由于CIMT是一个非侵入性参数,在常规临床实践中对PCI后患者进行CIMT的随访测量将有助于预测再狭窄率。