Feng Qiang, Zhao Ying, Wang Haiyan, Zhao Jiayu, Wang Xun, Shi Jianping
Department of Cardiology, Handan Central Hospital, Handan, China.
Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Front Cardiovasc Med. 2022 Aug 11;9:857922. doi: 10.3389/fcvm.2022.857922. eCollection 2022.
As a second-generation drug-eluting stent, the restenosis risk factors of the everolimus-eluting stent (EES) lack sufficient evidence. Therefore, the study investigated the in-stent restenosis occurrence and its predictive factors among patients with coronary heart disease (CHD) who underwent percutaneous coronary intervention (PCI) with EES.
Totally, 235 patients with CHD who underwent PCI with EES were included. At 1 year post PCI with EES (or earlier if clinically indicated), coronary angiography was performed to evaluate the in-stent restenosis status.
Within 1 year post-operation, 20 patients developed in-stent restenosis while 215 patients did not develop in-stent restenosis, resulting in a 1-year in-stent restenosis rate of 8.5%. Diabetes mellitus, hypercholesteremia, hyperuricemia, fasting blood glucose, serum uric acid (SUA), high-sensitivity C-reactive protein (HsCRP), target lesions in the left circumflex artery, patients with two target lesions, length of target lesions and length of stent positively correlated with in-stent restenosis risk, while high-density lipoprotein cholesterol negatively associated with in-stent restenosis risk. Notably, diabetes mellitus, hypercholesteremia, SUA, HsCRP levels, and patients with two target lesions were independent predictive factors for in-stent restenosis risk by multivariate logistic regression analysis. Then, the in-stent restenosis risk prediction model was established based on these independent predictive factors, which exhibited an excellent value in predicting in-stent restenosis risk (area under the curve: 0.863; 95% CI: 0.779-0.848) by receiver operating characteristic analysis.
In-stent restenosis risk prediction model, consisting of diabetes mellitus, hypercholesteremia, SUA, HsCRP, and patients with two target lesions, may predict in-stent restenosis risk in patients with CHD who underwent post-PCI with EES.
作为第二代药物洗脱支架，依维莫司洗脱支架（EES）再狭窄的危险因素缺乏充分证据。因此，本研究调查了接受EES经皮冠状动脉介入治疗（PCI）的冠心病（CHD）患者的支架内再狭窄发生率及其预测因素。
共纳入235例接受EES PCI的CHD患者。在EES PCI术后1年（或临床指征需要时更早），进行冠状动脉造影以评估支架内再狭窄情况。
术后1年内，20例患者发生支架内再狭窄，215例患者未发生支架内再狭窄，1年支架内再狭窄率为8.5%。糖尿病、高胆固醇血症、高尿酸血症、空腹血糖、血清尿酸（SUA）、高敏C反应蛋白（HsCRP）、左旋支动脉的靶病变、有两个靶病变的患者、靶病变长度和支架长度与支架内再狭窄风险呈正相关，而高密度脂蛋白胆固醇与支架内再狭窄风险呈负相关。值得注意的是，通过多因素logistic回归分析，糖尿病、高胆固醇血症、SUA、HsCRP水平以及有两个靶病变的患者是支架内再狭窄风险的独立预测因素。然后，基于这些独立预测因素建立了支架内再狭窄风险预测模型，通过受试者工作特征分析，该模型在预测支架内再狭窄风险方面具有优异价值（曲线下面积：0.863；95%CI：0.779 - 0.848）。
由糖尿病、高胆固醇血症、SUA、HsCRP以及有两个靶病变的患者组成的支架内再狭窄风险预测模型，可能预测接受EES PCI术后CHD患者的支架内再狭窄风险。
