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甘油三酯-葡萄糖指数预测经皮介入支架治疗髂动脉狭窄患者支架内再狭窄。

Triglyceride-glucose index for predicting in-stent restenosis in patients with iliac artery stenosis after percutaneous intervention with stents.

机构信息

Department of Cardiovascular Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2024 Feb;28(3):1015-1026. doi: 10.26355/eurrev_202402_35337.

Abstract

OBJECTIVE

To evaluate the triglyceride-glucose index (TyG index) for predicting in-stent restenosis in patients with iliac artery stenosis after percutaneous intervention with stents.

PATIENTS AND METHODS

Subjects with iliac artery stenosis, who underwent an iliac stent intervention and were followed up for at least 2 years were included in the study. Subjects were grouped according to TyG index (Group A, TyG index ≤8.848; Group B 8.849 ≤TyG index ≤9.382 and Group C TyG index ≥9.383). The subject's baseline characteristics, blood parameters, claudication distance, Transatlantic Intersociety Consensus classification, target lesion localization, stent direction, number of stents that were applied, and stent type were noted. Pre- and 1st and 2nd-year post-procedure Rutherford statuses, ankle-brachial index, and stenosis degree were recorded. To calculate the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), Group B and Group C were combined and compared with Group A.

RESULTS

In total, 255 subjects were evaluated (female, n=77-30.2%, male, n=178-69.8%). The mean age of the subjects was 66.00±10.00 years (range from 39 to 90 years). The pre-procedure Rutherford measurements were significantly different among the groups (p=0.001). The rates of mild claudication and resting pain in Group A were higher than those in Groups B and C. The rate of moderate claudication in Group C was higher than that in Groups A and B. The rate of severe claudication in Group B was higher than that in Groups A and C. One year after the procedure, there were more asymptomatic cases in Group A than in Groups B and C (p=0.001). The rate of mild claudication in Group C was lower than that in Groups A and B. The rate of moderate claudication in Group C was higher than that in Group A. The rate of severe claudication in Group C was higher than that in Groups A and B. Two years after the procedure, the Rutherford measurements and the rates of mild claudication in Groups A and B were higher than those in Group C. The rate of severe claudication in Group C was higher than that in Groups A and B (p=0.001). One year after the procedure, the computed tomography angiography (CTA) measurements and the rate of full patency in Group A were higher than that in Groups B and C. The rate of 0-50% stenosis in Group B was higher than that in Groups A and C. The rate of 50-70% stenosis in Group C was higher than that in Group A. Two years after the procedure, the CTA measurements and the rates of 70-99% stenosis and 100% occlusion in Group C were higher than those in Groups A and B. The TyG index has high specificity and NPV. However, specificity and PPV levels were found to be quite low.

CONCLUSIONS

The TyG index was found to be an easy-to-use marker for predicting in-stent restenosis in patients with iliac artery stenosis after percutaneous intervention with stents.

摘要

目的

评估甘油三酯-葡萄糖指数(TyG 指数)在经皮支架介入治疗髂动脉狭窄患者支架内再狭窄中的预测价值。

方法

纳入接受髂动脉支架介入治疗并至少随访 2 年的髂动脉狭窄患者。根据 TyG 指数(A 组,TyG 指数≤8.848;B 组,8.849≤TyG 指数≤9.382;C 组,TyG 指数≥9.383)对患者进行分组。记录患者的基线特征、血液参数、跛行距离、跨大西洋介入学会共识分类、靶病变定位、支架方向、应用的支架数量和支架类型。记录术前和术后第 1 年、第 2 年的 Rutherford 状态、踝肱指数和狭窄程度。将 B 组和 C 组合并并与 A 组进行比较,以计算灵敏度、特异性、阳性预测值(PPV)和阴性预测值(NPV)。

结果

共评估了 255 例患者(女性,n=77-30.2%;男性,n=178-69.8%)。患者的平均年龄为 66.00±10.00 岁(年龄范围为 39 岁至 90 岁)。术前 Rutherford 测量值在各组之间存在显著差异(p=0.001)。A 组轻度跛行和静息痛的发生率高于 B 组和 C 组。C 组中度跛行的发生率高于 A 组和 B 组。B 组重度跛行的发生率高于 A 组和 C 组。术后 1 年,A 组无症状病例比例高于 B 组和 C 组(p=0.001)。C 组轻度跛行的发生率低于 A 组和 B 组。C 组中度跛行的发生率高于 A 组。C 组重度跛行的发生率高于 A 组和 B 组。术后 2 年,A 组和 B 组的 Rutherford 测量值和轻度跛行的发生率均高于 C 组。C 组重度跛行的发生率高于 A 组和 B 组(p=0.001)。术后 1 年,A 组的计算机断层扫描血管造影(CTA)测量值和完全通畅率均高于 B 组和 C 组。B 组 0-50%狭窄的发生率高于 A 组和 C 组。C 组 50-70%狭窄的发生率高于 A 组。术后 2 年,C 组的 CTA 测量值和 70-99%狭窄及 100%闭塞的发生率均高于 A 组和 B 组。TyG 指数具有较高的特异性和 NPV。然而,特异性和 PPV 水平较低。

结论

TyG 指数是一种简单易用的预测髂动脉狭窄患者经皮支架介入治疗后支架内再狭窄的标志物。

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