Gu Ning, Liu Zhijiang, Wang Zhenglong, Shen Changyin, Zhang Wei, Tian Hongqin, Wang Xi, Yang Shuangya, Zhao Ranzun, Shi Bei
Department of Cardiology, Affiliated Hospital of Zunyi Medical University.
Int Heart J. 2024;65(1):4-12. doi: 10.1536/ihj.23-058.
Neoatherosclerosis is a major cause of stent failure after percutaneous coronary intervention. Metabolism such as hyperuricemia is associated with in-stent restenosis (ISR). However, the association between serum uric acid (sUA) levels and in-stent neoatherosclerosis (ISNA) has never been validated.A total of 216 patients with 220 ISR lesions who had undergone optical coherence tomography (OCT) of culprit stents were included in this study. According to their sUA levels, eligible patients were divided into two groups [normal-sUA group: sUA < 7 mg/dL, n = 126, and high-sUA group: sUA ≥ 7 mg/dL, n = 90]. OCT findings were analyzed and compared between the normal- and high-sUA groups.The incidence of ISNA (63.0% versus 43.0%, P = 0.004) was significantly higher in the high-sUA group than in the normal-sUA group. Lipid plaques (66.3% versus 43.0%, P < 0.001) and thin-cap fibroatheroma (38.0% versus 18.0%, P = 0.001) were observed more frequently in the restenotic tissue structure in patients in the high-sUA group than in those in the normal-sUA group. Meanwhile, univariate (OR: 1.208, 95% CI: 1.037-1.407; P = 0.015) and multivariate (OR: 1.254, 95% CI: 1.048-1.501; P = 0.013) logistic regression analyses indicated that sUA levels were an independent risk factor for ISNA after adjusting for relevant risk factors.The high-sUA levels were an independent risk factor for the occurrence of neoatherosclerosis in patients with ISR via OCT.
新动脉粥样硬化是经皮冠状动脉介入治疗后支架失败的主要原因。高尿酸血症等代谢异常与支架内再狭窄(ISR)相关。然而,血清尿酸(sUA)水平与支架内新动脉粥样硬化(ISNA)之间的关联尚未得到证实。
本研究纳入了220个罪犯支架接受光学相干断层扫描(OCT)的216例ISR病变患者。根据sUA水平,符合条件的患者分为两组[正常sUA组:sUA<7mg/dL,n=126;高sUA组:sUA≥7mg/dL,n=90]。分析并比较正常sUA组和高sUA组的OCT结果。
高sUA组的ISNA发生率(63.0%对43.0%,P=0.004)显著高于正常sUA组。高sUA组患者再狭窄组织结构中脂质斑块(66.3%对43.0%,P<0.001)和薄帽纤维粥样瘤(38.0%对18.0%,P=0.001)的观察频率高于正常sUA组。同时,单因素(OR:1.208,95%CI:1.037-1.407;P=0.015)和多因素(OR:1.254,95%CI:1.048-1.501;P=0.013)逻辑回归分析表明,在校正相关危险因素后,sUA水平是ISNA的独立危险因素。
通过OCT检测,高sUA水平是ISR患者发生新动脉粥样硬化的独立危险因素。