Çalapkulu Yunus, Erdoğan Mehmet, Aslan Abdullah Nabi, Akar Nihal, Bulguroğlu Serkan, Kardeşler Burak, Erdöl Mehmet Akif
Department of Cardiology, University of Health Sciences, Ankara Mamak State Hospital, Ankara, Türkiye.
Department of Cardiology, Ankara Yıldırım Beyazıt University Medical School, Ankara, Türkiye.
Anatol J Cardiol. 2025 May 29;29(9):503-11. doi: 10.14744/AnatolJCardiol.2025.5407.
This study investigated the relationship between whole blood viscosity (WBV) and in-stent restenosis (ISR) in patients with prior coronary stent implantation who underwent coronary angiography (CAG) for chronic coronary syndrome (CCS).
In this retrospective case-control study, 802 patients who underwent CAG with suspected ISR were included. In-stent restenosis was defined as ≥50% stenosis within the stent or within 5 mm of its edges. Patients were divided into an ISR group (n = 342) and a control group without ISR (n = 460). Whole blood viscosity was calculated using both high-shear rate viscosity (HSR) and low-shear rate viscosity (LSR).
Whole blood viscosity levels were significantly higher in the ISR group for both HSR (16.8 ± 1.0 vs. 15.6 ± 0.9 cP, P < .001) and LSR (83.1 ± 8.4 vs. 80.8 ± 8.0 cP, P < .001). Receiver-operating characteristic curve (ROC) analysis showed strong predictive power for ISR (area under the curve [AUC] 0.84 for LSR and 0.82 for HSR). Kaplan-Meier analysis demonstrated significantly lower ISR-free survival in patients with high WBV (P < .001). Multivariate Cox regression identified both HSR and LSR as independent predictors of ISR.
Increased WBV is independently linked to ISR and may contribute to its development via endothelial inflammation and vascular remodeling. Whole blood viscosity demonstrates potential utility as a biomarker for the identification of CCS patients susceptible to ISR.
本研究调查了既往有冠状动脉支架植入史、因慢性冠状动脉综合征（CCS）接受冠状动脉造影（CAG）的患者全血粘度（WBV）与支架内再狭窄（ISR）之间的关系。
在这项回顾性病例对照研究中，纳入了802例疑似ISR并接受CAG的患者。支架内再狭窄定义为支架内或其边缘5mm内狭窄≥50%。患者分为ISR组（n = 342）和无ISR的对照组（n = 460）。使用高剪切率粘度（HSR）和低剪切率粘度（LSR）计算全血粘度。
ISR组的全血粘度水平在HSR（16.8±1.0 vs. 15.6±0.9 cP，P <.001）和LSR（83.1±8.4 vs. 80.8±8.0 cP，P <.001）方面均显著更高。受试者工作特征曲线（ROC）分析显示对ISR具有较强的预测能力（LSR曲线下面积[AUC]为0.84，HSR为0.82）。Kaplan-Meier分析表明，高WBV患者的无ISR生存率显著更低（P <.001）。多变量Cox回归确定HSR和LSR均为ISR的独立预测因素。
WBV升高与ISR独立相关，可能通过内皮炎症和血管重塑促进其发展。全血粘度作为识别易发生ISR的CCS患者的生物标志物具有潜在效用。
