Correlation Study Between SII,NHR And Coronary Stent Restenosis

Objective:To explore the correlation between systemic immune inflammation index(SII),neutrophil to high-density lipoprotein cholesterol ratio(NHR)and coronary stent restenosis(ISR),and to explore whether SII and NHR can provide predictive value for stent restenosis in coronary heart disease patients in clinical work.Subjects and methods:(1)Subjects: A total of 137 patients who underwent PCI in Xiangya Hospital of Central South University between January 1,2016 and December 30,2021 and underwent coronary angiography after surgery.The included subjects were classified into 47 patients in the ISR group and 90 in the non-ISR groups based on the presence of in-stent restenosis.(2)Methods: The basic clinical data,Laboratory tests before stenting(the first time)and coronary angiography(the second time),coronary angiography results and stent implantation of all the included objects were collected through the electronic medical record system.The degree of global coronary artery stenosis was quantified according to the Gensini score.The independent associations of SII,NHR and ISR were analyzed after adjusting for confounders,and the predictive value of SII,NHR and both combined with traditional risk factors for ISR was analyzed using ROC curves.Result:1.Comparison of clinical baseline data between ISR and non-ISR groups: age,advanced age,gender,smoking,alcohol consumption,hypertension,diabetes,hyperlipidemia,coronary angiography review interval,CTO,and stent minimum diameter between the two groups(P>0.05).The mean number of stents,the number of coronary stenosis branches,the longest stent length,Gensini score,and the non-ISR group were significantly different in the ISR group(P<0.05).2.Comparison of two laboratory tests: WBC、NEUT #,PLT,LDL,SII,and NHR in the ISR group before stent implantation were significantly higher than those in the non-ISR group(P<0.05).The difference between TC and LDL in the ISR group was significant(P<0.05).WBC,NEUT #,LYMPH #,TC and LDL in non-ISR groups(P<0.05).3.Correlation between lipid and inflammation index: triglyceride NHR in lipid was positively correlated.There was a positive correlation between the total cholesterol and the lymphocyte count.HDL was negatively correlated with NHR and monocyte counts.LDL was positively associated with leukocyte count,platelet count,and lymphocyte count.4.Correlation analysis between SII,NHR and stent restenosis:Risk factors for ISR by univariate Logistic regression showed that the scaffold longest length,Gensini score,WBC in the first test item,NEUT #,PLT,TC,LDL,Hb A1 c,SII,and NHR were predictors of ISR(P<0.05).In multivariate Logistic regression analysis,Model 1 did not correct for any confounders,OR for ISR for SII as exposure factor was 1.001,NHR for ISR as exposure factor was 1.244,Model 2 corrected scaffold longest length and Gensini score on Model 1,OR was 1.001 and 1.223,Model 3corrected Hb A1 c on model 2,OR was 1.001 and 1.204(P<0.05).5.The ROC curve of the risk factors:ROC curve analysis yielded the area under the curve(AUC)of SII predicted ISR as 0.619,an optimal cutoff of 486.475,and a sensitivity of 64% and 56% specificity.NHR predicted an ISR with an AUC of 0.613,an optimal cutoff of 5.76,a sensitivity of 40%,and a specificity of 82%.The longest stent length,Gensini score,Hb A1 c,and LDL were selected as traditional risk factors,and the AUC and diagnostic specificity of NHR and SII were increased compared with traditional risk factors.6.Risk factors for the severity of coronary artery stiffness: SII and NHR were not used as risk factors for triple lesions and severe coronary stenosis(Gensini score≥89).Conclusion:1.A significant correlation between inflammatory and lipid indicators.2.SII and NHR showed significant associations with stent restenosis and were independent predictive risk factors for stent restenosis,with increasing AUC and diagnostic specificity of NHR and SII combined with traditional risk factors compared with traditional risk factors.3.SII and NHR could not be used as risk factors for predicting the severity of coronary stiffness.