Relationship Between Levels Of Plasma QKI And COX2 And In-stent Restenosis In Patients With Coronary Artery Disease After PCI

Objective: Percutaneous coronary intervention(PCI)is one of the important methods for the treatment of coronary artery disease(CAD).In-sent restenosis(ISR)after PCI for patients suffered from CAD is considered to be an essential factor affecting long-term outcomes and prognosis of this disease.This study aims to investigate the correlation between plasma Quaking(QKI)and cyclooxygenase 2(COX2)levels and ISR in patients with CAD.Methods:218 consecutive CAD patients who underwent coronary angiography and coronary arterial stenting were enrolled in this study,and 35 matched individuals from the physical examination center were included as a control group.After admission,clinical data of these two groups were collected.Plasma QKI and COX2 levels were measured by an enzyme-linked immune sorbent assay(ELISA)test.Follow-up angiography was performed 12 months after PCI.CAD patients were divided into NISR group(n=160)and ISR group(n=58)according to ISR occurrence based on the coronary angiography.The clinical data,coronary angiography,and stent features between NISR group and ISR group were compared,and multivariate logistic regression was used to explore the factors influencing ISR.The occurrence of major adverse cardiovascular events(MACE)1 year after operation was recorded.58 patients with ISR were divided into the MACE group(n=24)and the non-MACE group(n=34),classified according to the occurrence of MACE,and the plasma QKI and COX2 levels were compared between these two groups.ROC curves were utilized to analyze the diagnostic value of plasma levels of QKI and COX2 for ISR and MACE occurrences in patients after PCI.Results: Compared with the control group,plasma QKI and COX2 levels in the CAD group decreased significantly(all P<0.001).Compared with the NISR group,the levels of QKI and COX2 also reduced markedly in the ISR group(all P<0.001).In contrast,the levels of high sensitivity C-reactive protein(hs-CRP)and glycosylated hemoglobin(Hb Alc)were significantly increased(all P<0.001).The level of COX2 was negatively correlated with hs-CRP(P=0.003).Multivariate Logistic regression analysis showed that plasma QKI and COX2 were protective factors for in-stent restenosis after PCI,while hsCRP was a risk factor.ROC curve analysis shows that the sensitivity and specificity of plasma QKI for evaluating the predictive value of ISR were 77.5% and 66.5%,and the sensitivity and specificity of plasma COX2 for assessing the predictive value of ISR were 80.0% and 70.7%.The sensitivity and specificity of plasma QKI combined with COX2 for evaluating the predictive value of ISR were 81.3% and 74.1%,respectively.The sensitivity and specificity of plasma QKI for evaluating the prognosis of ISR were 75.0% and 64.7%,respectively.The sensitivity and specificity of plasma COX2 for evaluating the prognosis of ISR were 75.0% and 70.6%,respectively.The sensitivity and specificity of plasma QKI combined with COX2 for prognostic evaluation of ISR were 81.7% and 79.4%,respectively.The sensitivity and specificity of plasma COX2 combined with QKI for evaluating ISR and MACE occurrences in patients after PCI were better than those of COX2 or QKI alone(P<0.001).Conclusion: Plasma QKI and COX2 may be one of the protective factors for ISR,which also can predict an ISR patient’s prognosis.