Correlation Between SII,SIRI,ApoB/ApoA1 Ratio And Drug-eluting Stent Restenosis

Background :Percutaneous coronary intervention(PCI)has become the preferred modality for revascularization in patients with coronary artery disease,but the post-procedural complications of restenosis remain a difficult challenge to completely resolve.Studies have shown that inflammatory response is one of the important causes of in-stent restenosis(ISR),and systemic immune inflammation index(SII),systemic inflammatory response index(SIRI)systemic inflammatory response index(SIRI)are new inflammatory indices proposed so far,which may be important factors involved in the mechanism of ISR.Apolipoprotein B/(apolipoprotein B,Apo B)reflects the atherogenic effect while apolipoprotein A1(Apo A1)has an anti-atherogenic effect,and the Apo B/Apo A1 ratio reflects the balance between these two effects,while recent studies have shown that new atherogenesis is a key factor in ISR mechanism.In this paper,we investigate the role of SII,SIRI,and Apo B/Apo A1 in restenosis after drugeluting stent implantation.Objective :Through retrospective analysis,the effects of SII,SIRI,and Apo B / Apo A1 on instent restenosis after coronary stent implantation were explored,which provided certain predictive value for the occurrence and development of in-stent restenosis.Methods :The medical records related to 298 patients with coronary artery disease who underwent coronary drug-eluting stent implantation for the first time at the Department of Cardiovascular Medicine,The Second Hospital of Jilin University from January2014 to December 2022 and had one coronary arteriography(CAG)review more than6 months after the procedure were retrospectively collected and analyzed according to the coronary arteriography reviewed after the procedure.The results were divided into two groups,the ISR group(n=54)and the non-ISR group(n=244).Basic clinical information(including age,gender,history of diabetes,history of hypertension,and other indicators),laboratory findings(erythrocytes,leukocytes,platelets,neutrophils,lymphocytes,monocytes,HDL cholesterol,triglycerides,LDL cholesterol,urea nitrogen,and other laboratory indicators),ancillary findings(left ventricular ejection fraction,left ventricular end-diastolic volume),the results of the enrolled patients’ coronary angiography results and stent characteristics(lesion site,number of diseased target vessels,number of stent implantations,longest length of single stent,minimum diameter of stent implantation,and other indicators).Correlations between SII,SIRI,Apo B/Apo A1,and ISR were analyzed using statistical methods.Result:1.In the comparison of laboratory tests and ancillary tests between the ISR and non-ISR groups,the differences in white blood cell count,neutrophil count,platelet count,platelet pressure,D-dimer,low-density lipoprotein cholesterol(LDL-C),total cholesterol,Apo B,Apo B/ Apo A1,SII,and SIRI were statistically significant(P < 0.05).2.Multi-factor logistic regression analysis with ISR as the dependent variable sho wed that SII(P<0.001,OR: 1.005,95% CI: 1.003-1.007),Apo B/Apo A1(P=0.024,OR:24.831,95% CI: 1.535-401.615)were the independent risk factor for the occurrence o f in-stent restenosis.3.ROC prediction curve analysis showed that the area under the ISR curve predi cted by SII was 0.774(95% CI: 0.713-0.834,P < 0.001),and the corresponding value of SII at the maximum of the Yordon index was 504.76,with a sensitivity of 87.00% a nd specificity of 55.30%;the area under the ISR curve predicted by Apo B/Apo A1 was0.677(95% CI: 0.596-0.758,P < 0.001),the value corresponding to Apo B/Apo A1 at t he maximum of the Jorden index was 0.58,with a sensitivity of 74.10% and a specific ity of 58.20%;the area under the ISR curve predicted by the combination of SII and A po B/Apo A1 was 0.822(95% CI: 0.767-0.877,P < 0.001),and when the Jorden index was maximum,the sensitivity was 87.00% and the specificity was 65.20%.Conclusion :1.SII,Apo B/ Apo A1 are predictable indicators of ISR after PCI.2.Both SII and Apo B/Apo A1 have a predictive value for the occurrence of restenosis in drug-eluting stents,and the combination of the two has a higher predictive value than their individual application.