Department of Cardiology, Adana City Training and Research Hospital; Adana-Turkey.
Department of Hematology, Faculty of Medicine, Hacettepe University; Ankara-Turkey.
Anatol J Cardiol. 2022 Feb;26(2):112-117. doi: 10.5152/AnatolJCardiol.2021.193.
Stent thrombosis (ST) is an uncommon but serious complication in patients undergoing percutaneous coronary intervention (PCI). This study aimed to investigate the effect of atherogenic index of plasma (AIP) on ST.
Among the 10,258 patients who underwent coronary angiography between January 2018 and December 2020, 239 patients who underwent PCI with the diagnosis of acute coronary syndrome (ACS) due to ST were included as the study group (ST group) and 459 patients who underwent percutaneous intervention for ACS and did not have any in-stent lesion as the control group (non-ST group). ST classification was done according to the Academic Research Consortium definition.
The mean age of the patients was 63.3±10.6 years (483 male, 69.2%). The groups were similar in terms of characteristic properties, comorbidities, and the drugs being used (p>0.05 for all). Drug eluting stents were used in 86.5% of the patients. In the ST group, the median time from stent implantation to thrombosis was 285 days. Mean AIP and the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) were statistically significantly higher in the ST group than in the controls (p<0.001 and p=0.018, respectively), and a positive correlation was observed between time from stent implantation to thrombosis and AIP and TG/HDL-C (rS=0.229, p=0.010 and rS=0.222, p=0.010, respectively). Multivariate logistic regression analysis revealed that stent length, prior ST elevation myocardial infarction, TG/HDL-C, and AIP were independent predictors of ST.
AIP is an easy calculable biomarker, and the performance of AIP to predict ST is better than TG/HDL-C.
支架血栓形成(ST)是经皮冠状动脉介入治疗(PCI)患者中一种罕见但严重的并发症。本研究旨在探讨血浆致动脉粥样硬化指数(AIP)对 ST 的影响。
在 2018 年 1 月至 2020 年 12 月期间接受冠状动脉造影的 10258 例患者中,纳入 239 例因 ST 而行 PCI 且诊断为急性冠状动脉综合征(ACS)的患者作为研究组(ST 组),并纳入 459 例因 ACS 而行经皮介入且无支架内病变的患者作为对照组(非 ST 组)。根据学术研究联盟的定义进行 ST 分类。
患者的平均年龄为 63.3±10.6 岁(483 例男性,69.2%)。两组在特征、合并症和使用的药物方面相似(所有 p 值均>0.05)。86.5%的患者使用药物洗脱支架。在 ST 组中,支架植入至血栓形成的中位时间为 285 天。ST 组的平均 AIP 和甘油三酯与高密度脂蛋白胆固醇比值(TG/HDL-C)显著高于对照组(均 p<0.001 和 p=0.018),支架植入至血栓形成的时间与 AIP 和 TG/HDL-C 呈正相关(rS=0.229,p=0.010 和 rS=0.222,p=0.010)。多变量逻辑回归分析显示,支架长度、既往 ST 抬高型心肌梗死、TG/HDL-C 和 AIP 是 ST 的独立预测因素。
AIP 是一种易于计算的生物标志物,其预测 ST 的性能优于 TG/HDL-C。