Correlation Between Lp-PLA2,SII And In-stent Restenosis After PCI In Patients With Acute Coronary Syndrome

Objective:To investigate the relationship between lipoprotein phospholipase A2(Lp-PLA2),systemic immunoinflammatory index(SII)and in-stent restenosis(ISR)in patients with acute coronary syndrome(ACS)after PCI,and to provide certain clinical reference for improving the prognosis of patients with ACS after PCI.Methods:Retrospectively screened the patients who received PCI treatment for ACS in the Department of Cardiology of Shanxi Provincial People’s Hospital from January 1,2015 to December 31,2019 and underwent coronary angiography review 12 to 48 months after surgery.According to the results of angiography review,they were divided into the in-stent restenosis group(ISR group)and the non-in-stent restenosis group(non-ISR group).Collect all into the group of patients with basic clinical data(including gender,age,body mass index,diabetes history,history of high blood pressure,smoking history,primary diagnosis and imaging review admission time interval),laboratory results(hs CRP,Lp PLA2,routine blood,blood lipid,renal function and other laboratory tests),results of coronary angiography and stent implantation(vascular lesions count number,review,stenting,single pieces of stents longest length,minimum diameter)and the commonly used drugs for coronary heart disease after operation.The correlation between Lp-PLA2,SII and the above factors and restenosis in stent after PCI was analyzed by statistical methods.Results:1.Comparison of basic clinical data,coronary artery lesions,stent characteristics and laboratory tests between ISR group and non-ISR group: diabetes history,Hb A1 c,Lp-PLA2,Neut# and SII in ISR group were all higher than those in non-ISR group,with statistical significance(P < 0.05).Between the two groups of patients age,gender,BMI,smoking history,history of high blood pressure,primary diagnosis,admission review time interval,vascular lesion counts,stents minimum diameter,length,the largest number of stents,fasting glucose,uric acid,creatinine and urinary inhibition C,TC,TG,LDL-C,hdl-c leel,HCY,Acr,hs CRP,WBC,MONO#,PLT,LYMPH#,coronary heart disease drugs commonly used by differences had no statistical significance(P > 0.05).2.Multivariate Logistic regression analysis between ISR group and non-ISR group showed that Hb A1c(P=0.007,OR=2.034,95%CI: 1.220-3.391),Lp-PLA2(P=0.045,OR=1.005,95%CI:1.000 ～ 1.009)and SII(P=0.016,OR=1.005,95%CI: 1.001-1.009)were independent risk factors for ISR,while diabetes and NEUT# had no statistical significance in this regression(P > 0.05).3.ROC curve analysis showed that the area under the ISR curve predicted by SII was 0.678(95%CI: 0.555 ～ 0.802,P=0.014),and the corresponding value of SII was669.695 when the Youden index was the maximum;The predicted area under ISR curve of Lp-PLA2 was 0.662(95%CI: 0.542 ～ 0.783,P=0.025),and the corresponding value of Lp-PLA2 was 213.335 when the Youden index was at its maximum.Conclusion:1.The levels of SII and Lp-PLA2 in ISR patients are higher than those in non-ISR patients,which are independent risk factors for ISR and can be used to predict the occurrence of ISR,further explaining the importance of inflammatory response in the occurrence of ISR and providing ideas for the prevention of ISR.2.Hb A1 c is also a risk factor for ISR.3.Patients with a history of diabetes and high preoperative neutrophils were more likely to develop ISR after PCI.