Gao Yixuan, Gu Ning, Zhou Yanna, Wang Yan, Zhao Ranzun, Shi Bei
Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149 of Road Dalian, District Huichuan, Zunyi, 563000, China.
Department of Epidemiology and Health Statistics, Zunyi Medical University, Zunyi, 563000, China.
Sci Rep. 2025 Jul 1;15(1):21304. doi: 10.1038/s41598-025-05441-y.
The relationship between in-stent neoatherosclerosis (ISNA) and chronic kidney disease (CKD) was investigated among patients exhibiting in-stent restenosis (ISR) after drug-eluting stent (DES) implantation. A total of 220 patients with confirmed in-stent restenosis (ISR) via coronary arteriography between 2020 and 2023 were enrolled. Patients were stratified into three groups based on estimated glomerular filtration rate (eGFR) levels: (1) normal renal function (eGFR ≥ 90 mL/min/1.73 m², n = 80), (2) mild renal impairment (60 ≤ eGFR < 90 mL/min/1.73 m², n = 86), and (3) kidney failure (eGFR < 60 mL/min/1.73 m², n = 54). Baseline clinical characteristics, angiographic parameters, and optical coherence tomography (OCT) data were collected and analyzed across all groups. No significant differences in angiographic characteristics were found between the three groups (p > 0.05). Patients with kidney failure demonstrated significantly higher rates of both in-stent neoatherosclerosis (ISNA) (68.5% vs. 46.5% vs. 42.5%; p < 0.05) and thin-cap fibroatheroma (TCFA) within ISR lesions (40.7% vs. 22.1% vs. 22.5%; p < 0.05) compared to those with mild or normal renal function, respectively. Lower eGFR levels were associated with a higher incidence of ISNA and reduced neointima stability.
在药物洗脱支架（DES）植入后出现支架内再狭窄（ISR）的患者中，研究了支架内新生动脉粥样硬化（ISNA）与慢性肾脏病（CKD）之间的关系。共有220例在2020年至2023年期间经冠状动脉造影确诊为支架内再狭窄（ISR）的患者入组。根据估计肾小球滤过率（eGFR）水平将患者分为三组：（1）肾功能正常（eGFR≥90 mL/min/1.73 m²，n = 80），（2）轻度肾功能损害（60≤eGFR＜90 mL/min/1.73 m²，n = 86），以及（3）肾衰竭（eGFR＜60 mL/min/1.73 m²，n = 54）。收集并分析了所有组的基线临床特征、血管造影参数和光学相干断层扫描（OCT）数据。三组之间在血管造影特征方面未发现显著差异（p＞0.05）。与轻度肾功能或肾功能正常的患者相比，肾衰竭患者的支架内新生动脉粥样硬化（ISNA）发生率（分别为68.5%对46.5%对42.5%；p＜0.05）和ISR病变内薄帽纤维粥样瘤（TCFA）发生率（分别为40.7%对22.1%对22.5%；p＜0.05）均显著更高。较低的eGFR水平与ISNA的较高发生率和新生内膜稳定性降低相关。
