08 January 2019 : Clinical Research
Factors Influencing Stent Restenosis After Percutaneous Coronary Intervention in Patients with Coronary Heart Disease: A Clinical Trial Based on 1-Year Follow-Up
Gong Cheng12BCDEF, Feng-jun Chang1BCD, Yi Wang1CDE, Peng-Hua You1CD, Hai-chao Chen1D, Wen-qi Han1F, Jun-wei Wang1D, Ni-er Zhong3E, Zhi-qian Min4ABCDF*DOI: 10.12659/MSM.908692
Med Sci Monit 2019; 25:240-247
Abstract
BACKGROUND: This study observed the incidence of in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) and discusses the risk factors of ISR based on clinical data, coronary angiography, and stent features, to provide a theoretical basis for the prevention and treatment of ISR.
MATERIAL AND METHODS: We selected 1132 cases who received stent implantation at the Shaanxi People’s Hospital from June 2014 to June 2016 and were followed up by coronary angiography within 1 year. Based on coronary angiography, the cases were divided into ISR and non-ISR groups. ISR was defined as a reduction in lumen diameter by over 50% after PCI. The ISR group consisted of 93 cases and the non-ISR group consisted of 1039 cases. Medical history, biochemical indicators, features of coronary artery lesions, and stent status were analyzed retrospectively. Risk factors of ISR were identified by univariate and multivariate logistic regression analyses.
RESULTS: Among 1132 cases, 93 cases had ISR, with the overall incidence of 8.21%. Univariate and multivariate logistic regression analyses indicated that postoperative hypersensitive C-reactive protein (hs-CRP) levels (OR=2.309, 1.579–3.375 mg/L), postoperative homocysteine (HCY) levels (OR=2.202, 1.268–3.826 μmol/L), history of diabetes (OR=1.955,1.272–3.003), coronary bifurcation lesions (OR=3.785, 2.246–6.377), and stent length (OR=1.269, 1.179–1.365 mm) were independent risk factors of ISR after PCI (P<0.05).
CONCLUSIONS: Elevated hs-CRP and HCY levels after PCI, history of diabetes, coronary bifurcation lesions, and greater stent length were associated with a higher risk of ISR. Patients with a higher risk of ISR should receive routine follow-up and intense medication management after PCI to control the risk factors and to reduce ISR.
Keywords: Behavioral Risk Factor Surveillance System, Coronary Disease, percutaneous coronary intervention, C-Reactive Protein, Coronary Angiography, Coronary Artery Disease, Coronary Restenosis, Coronary Vessels, Follow-Up Studies, homocysteine, Risk Factors, Stents
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