Department of Cardiology, Affiliated Hospital of Chengde Medical College, No. 36 Nanyingzi Street, Chengde, 067000, Hebei Province, People's Republic of China.
Department of Cardiology, Chengde Central Hospital, Chengde, People's Republic of China.
BMC Cardiovasc Disord. 2020 Dec 4;20(1):510. doi: 10.1186/s12872-020-01798-2.
Percutaneous coronary intervention (PCI) is a common treatment for patients with coronary heart disease, and intra-stent restenosis (ISR) is a serious complication after PCI. It's necessary to identify the potential risk factors to provide evidence for the prevention of ISR.
The patients who underwent coronary angiography 1 year after PCI in our hospital from January 2017 to May 2019 were selected. The characteristics and results of clinical examination of ISR and no-ISR patients were compared, Multivariate logistic regression analyses were performed to identify the risk factors.
A total of 209 patients were included, the incidence of ISR after PCI was 30.62%. There were significant differences on the hypertension, diabetes, number of coronary artery lesions, reasons for stent implantation, the diameter of stent, the length of stent and stent position between ISR group and no-ISR patients (all p < 0.05). The LDL-C in ISR groups was significantly higher than that of no-ISR group (p = 0.048), there were no significant differences between two groups in FPG, TG, TC, HDL-C, Apo A1, Apo B, LP-a and glycated haemoglobin (all p > 0.05). The hypertension (OR 4.30, 95% CI 1.12-9.34), diabetes (OR 5.29, 95% CI 1.25-9.01), number of coronary artery lesions ≥ 2 (OR 4.84, 95% CI 1.21-9.55), LDL-C ≥ 1.9 mmol/L (OR 5.93, 95% CI 2.29-10.01), unstable angina (OR 2.92, 95% CI 1.20-4.55), left anterior descending artery (OR 4.01, 95% CI 1.73-7.58), diameter of stent ≥ 3 mm (OR 5.42, 95% CI 1.24-10.84), the length of stent > 20 mm (OR 3.06, 95% CI 1.19-5.22) were the independent risk factor for ISR (all p < 0.05).
It is necessary to take preventive measures against these risk factors to reduce ISR, and studies with larger sample size and longer follow-up on this issue are needed in the future.
经皮冠状动脉介入治疗(PCI)是冠心病患者的常见治疗方法,支架内再狭窄(ISR)是 PCI 后的严重并发症。有必要识别潜在的危险因素,为预防 ISR 提供证据。
选取 2017 年 1 月至 2019 年 5 月我院 PCI 术后 1 年行冠状动脉造影的患者。比较 ISR 与非 ISR 患者的临床检查特征和结果,采用多因素 logistic 回归分析确定危险因素。
共纳入 209 例患者,PCI 后 ISR 的发生率为 30.62%。ISR 组与非 ISR 组在高血压、糖尿病、冠状动脉病变数量、支架植入原因、支架直径、支架长度和支架位置等方面存在显著差异(均 P<0.05)。ISR 组的 LDL-C 明显高于非 ISR 组(P=0.048),两组的 FPG、TG、TC、HDL-C、Apo A1、Apo B、LP-a 和糖化血红蛋白无显著差异(均 P>0.05)。高血压(OR 4.30,95%CI 1.12-9.34)、糖尿病(OR 5.29,95%CI 1.25-9.01)、冠状动脉病变数≥2(OR 4.84,95%CI 1.21-9.55)、LDL-C≥1.9mmol/L(OR 5.93,95%CI 2.29-10.01)、不稳定型心绞痛(OR 2.92,95%CI 1.20-4.55)、前降支(OR 4.01,95%CI 1.73-7.58)、支架直径≥3mm(OR 5.42,95%CI 1.24-10.84)、支架长度>20mm(OR 3.06,95%CI 1.19-5.22)是 ISR 的独立危险因素(均 P<0.05)。
有必要针对这些危险因素采取预防措施,以降低 ISR 的发生,未来需要进行更大样本量和更长随访时间的相关研究。