Risk Factors Of In-stent Restenosis And The Correlation Between LDL-C/HDL-C Ratio And ISR

ObjectiveTo investigate the risk factors of in-stent restenosis and the value of LDL-C/HDL-C ratio in predicting ISR by analyzing the general clinical data,biochemical indexes,blood lipid level and related blood lipid ratio in patients with coronary artery disease after percutaneous coronary intervention(PCI).MethodsFor this study,we collected 317 patients(216 males and 101 females)who received coronary angiography(CAG)for the first time and were definitely diagnosed with coronary heart disease from December 2016 to December 2017 in the fourth ward of department of cardiology,the First Affiliated Hospital of Zhengzhou University,and all of them underwent stent implantation.All patients were hospitalized to underwent CAG through radial/femoral artery for review after PCI operation for 8~12 month.The subjects were divided into ISR group(67cases,49 males and 18 females)and non-ISR group(250 cases,167 males and 83 females)based on CAG outcome.General clinical data of each patient were retrospectively collected,including gender,age,hypertension and diabetes history,smoking and drinking history.Biochemistry index were measured in the next morning after hospitalized,including fasting blood glucose(Glu),uric acid(UA),serum total bilirubin(TBIL),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C),and then calculated the non-high-density lipoprotein cholesterol(non-HDL-C)and TC/HDL-C,non-HDL-C/ HDL-C,LDL-C/HDL-C.Analysis the relationship between ISR and the general clinical characteristics,blood lipid level,lipid ratio of the two groups.Statistical analysis was performed with SPSS 22.0,P<0.05 was considered to be significant difference between the two groups.Results1.There was no significant difference in age,sex,smoking and drinking history,hypertension,fasting blood glucose,total bilirubin,uric acid,creatinine,triglyceride and LVEF(%)between the two groups(P>0.05,table 1,table 2);2.There was statistical difference in diabetes mellitus between ISR group and non-ISR group(P<0.05,table 1);3.TC,LDL-C,non-HDL-C,TC/HDL-C,non-HDL-C/HDL-C,LDL-C/HDL-C in ISR group was higher than that in non-ISR group,while HDL-C was lower than that in non-ISR group,there was statistical difference between the two groups(P<0.05,table 2);4.Multivariate logistic regression analysis showed that LDL-C,LDL-C/HDL-C,diabetes mellitus were independent risk factors for in-stent restenosis(P<0.05,table 3);5.ROC curve analysis showed that LDL-C/HDL-C could predict in-stent stenosis.The sensitivity and specificity were 60% and 86%,respectively.The area under the curve was 0.76(P<0.01,figure 1).ConclusionDiabetes mellitus,LDL-C,LDL-C/HDL-C are closely related to the occurrence of ISR,and they are independent risk factors of ISR.LDL-C/HDL-C ratio can be used as a reliable index for prevention of ISR after PCI.