Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
BMC Cardiovasc Disord. 2024 Jun 14;24(1):304. doi: 10.1186/s12872-024-03955-3.
Stent restenosis is a relatively common phenomenon among patients with coronary heart disease undergoing percutaneous coronary intervention (PCI). It seems that a set of clinical, laboratory, and even genetic factors make people susceptible to such a phenomenon and in fact, this is multi-factorial. We aimed to first determine the underlying clinical and laboratory risk factors for the occurrence of stent re-stenosis after PCI based on a systematic review study, and after that, through a bioinformatics study, to evaluate the related genes and microRNAs with the occurrence of stent re-stenosis.
In the first step, the manuscript databases including Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane were deeply searched by the two blinded investigators for all eligible studies based on the considered keywords to introduce clinical and laboratory determinants of stent re-stenosis. In the bioinformatic phase, and following a review of the literature to identify genes and microRNAs involved in restenosis, the interaction of each gene with other genes associated with stent re-stenosis was determined by GeneMANIA network analysis and Cytoscape software. Overall, 67 articles (including 40,789 patients) on clinical and biochemical predictors for stent restenosis and 25 articles on genetic determinants of this event were eligible for the final analysis. The predictors for this event were categorized into four subgroups patient-based parameters including traditional cardiovascular risk profiles, stent-based parameters including type and diametric characteristics of the stents used, coronary lesion-based parameters including several two target lesions and coronary involvement severity and laboratory-based parameters particularly related to activation of inflammatory processes. In the bioinformatic phase, we uncovered 42 genes that have been described to be involved in such a phenomenon considering a special position for genes encoding inflammatory cytokines. Also, 12 microRNAs have been pointed to be involved in targeting genes involved in stent re-stenosis.
The incidence of stent re-stenosis will be the result of a complex interaction of clinical risk factors, laboratory factors mostly related to the activation of inflammatory processes, and a complex network of gene-to-gene interactions.
经皮冠状动脉介入治疗（PCI）后，支架再狭窄是冠心病患者较为常见的现象。似乎有一组临床、实验室甚至遗传因素使人们容易受到这种现象的影响，事实上，这是多因素的。我们的目的是首先通过系统综述研究确定 PCI 后支架再狭窄发生的潜在临床和实验室危险因素，然后通过生物信息学研究评估与支架再狭窄发生相关的基因和 microRNAs。
在第一步中，两位盲法研究者通过深入搜索 Medline、Web of Knowledge、Google Scholar、Scopus 和 Cochrane 等文献数据库，根据考虑的关键词，对所有符合条件的研究进行了综述，以介绍支架再狭窄的临床和实验室决定因素。在生物信息学阶段，在对文献进行综述以确定与再狭窄相关的基因和 microRNAs 之后，通过 GeneMANIA 网络分析和 Cytoscape 软件确定了每个基因与其他与支架再狭窄相关的基因的相互作用。总体而言，有 67 篇关于支架再狭窄临床和生化预测因子的文章（包括 40789 例患者）和 25 篇关于该事件遗传决定因子的文章符合最终分析的条件。该事件的预测因子分为四个亚组：患者参数，包括传统心血管风险特征；支架参数，包括使用的支架类型和直径特征；冠状动脉病变参数，包括两个靶病变和冠状动脉受累严重程度；实验室参数，特别是与炎症过程激活相关的参数。在生物信息学阶段，我们发现了 42 个基因，这些基因被认为与炎症细胞因子的编码基因有特殊的关系，它们参与了这种现象。此外，已经有 12 个 microRNAs 被指出参与了针对支架再狭窄相关基因的靶向治疗。
支架再狭窄的发生率将是临床危险因素、实验室危险因素（主要与炎症过程的激活有关）和基因间复杂相互作用网络共同作用的结果。
