State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, No. 137, Liyushan Road, Urumqi, China.
Lipids Health Dis. 2021 Sep 29;20(1):118. doi: 10.1186/s12944-021-01553-2.
The present study was aimed to establish a prediction model for in-stent restenosis (ISR) in subjects who had undergone percutaneous coronary intervention (PCI) with drug-eluting stents (DESs).
A retrospective cohort study was conducted. From September 2010 to September 2013, we included 968 subjects who had received coronary follow-up angiography after primary PCI. The logistic regression analysis, receiver operator characteristic (ROC) analysis, nomogram analysis, Hosmer-Lemeshow χ statistic, and calibration curve were applied to build and evaluate the prediction model.
Fifty-six patients (5.79%) occurred ISR. The platelet distribution width (PDW), total cholesterol (TC), systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and lesion vessels had significant differences between ISR and non-ISR groups (all P < 0.05). And these variables were independently associated with ISR (all P < 0.05). Furthermore, they were identified as predictors (all AUC > 0.5 and P < 0.05) to establish a prediction model. The prediction model showed a good value of area under curve (AUC) (95%CI): 0.72 (0.64-0.80), and its optimized cut-off was 6.39 with 71% sensitivity and 65% specificity to predict ISR.
The incidence of ISR is 5.79% in CAD patients with DES implantation in the Xinjiang population, China. The prediction model based on PDW, SBP, TC, LDL-C, and lesion vessels was an effective model to predict ISR in CAD patients with DESs implantation.
本研究旨在建立经皮冠状动脉介入治疗（PCI）置入药物洗脱支架（DES）后发生支架内再狭窄（ISR）的预测模型。
采用回顾性队列研究。纳入 2010 年 9 月至 2013 年 9 月于我院接受初次 PCI 后进行冠状动脉随访造影的 968 例患者。采用逻辑回归分析、受试者工作特征（ROC）曲线分析、列线图分析、Hosmer-Lemeshow χ 检验和校准曲线构建并评估预测模型。
56 例（5.79%）患者发生 ISR。ISR 组与非 ISR 组血小板分布宽度（PDW）、总胆固醇（TC）、收缩压（SBP）、低密度脂蛋白胆固醇（LDL-C）及病变血管数比较，差异均有统计学意义（均 P<0.05）。上述变量均与 ISR 独立相关（均 P<0.05）。进一步将其确定为预测因素（均 AUC>0.5，P<0.05）建立预测模型。该预测模型的曲线下面积（AUC）为 0.72（95%CI：0.64~0.80），其最佳截断值为 6.39，预测 ISR 的灵敏度为 71%，特异度为 65%。
在中国新疆地区 CAD 患者 DES 置入后 ISR 的发生率为 5.79%。基于 PDW、SBP、TC、LDL-C 和病变血管建立的预测模型是预测 CAD 患者 DES 置入后 ISR 的有效模型。
