The Analysis Of Correlative Factors Of In-stent Restenosis After Drug-eiuting Coronary Stent Implantation

Objective: To analyze the influencing factors of in-stent restenosis after theintracoronary drug-eluting stent implantationMethods：The present study selects632patients with coronary heart disease from theFirst Hospital of Jilin University Centre for Diagnosis and Treatment of Cardiovasculardisease. There are492males and140females in the age of33-80and the average age of59.32±9.56. They underwent the drug-eluting stent implantation surgery successfully duringJanuary2010to January2013and had the countercheck for the coronary angiography at oneyear or one and a half years after the surgery. According to the results of the countercheck, thepatients are divided into ISR group of32cases with24males and8females and non-ISRgroup of600cases with468males and132females. The study collects their basic clinicaldata, biochemical indicators and the related data of coronary intervention in order to analyzethe influencing factors of in-stent restenosis.Results：It indicates that among632cases, there are32patients with the in-stentrestenosis, which is in the incidence of5.1%.The single factor analysis shows that:(1) ISRgroup and non-ISR group statistically differ in Diabetes (P <0.05). But there is no statisticaldifference (P>0.05) in age, gender, smoking, history of hypertension, left ventricular ejectionfraction, acute myocardial infarction, previous myocardial infarction and previous CABG.(2)Two groups statistically differ in serum total bilirubin level (11.12±4.12vs13.32±6.05P<0.05). But there is no difference (P>0.05) in fasting blood-glucose, total cholesterol,triglycerides, low-density lipoprotein and high-density lipoprotein.(3) Two groupsstatistically differ in stent diameter (2.91±0.38vs3.07±0.41P <0.05), stent length (27.10±6.72vs23.92±6.98P <0.05), and bifurcation lesions (P <0.05). But there is no difference(P>0.05) in the number of stent implantation and diseased vessels, the lesion, the level of presurgical stenosis, chronic total occlusions and diffuse lesion. Logistic regression analysisindicates that diabetes (OR=2.350,95%CI1.894-3.012), stent length (OR=1.654,95%CI1.448-2.084) and bifurcation lesions (OR=1.896,95%CI1.683-2.136) are three risky factorsfor the coronary in-stent restenosis. However, the protective factors tend to be the higherserum total bilirubin concentration (OR=0.846,95%CI0.798-0.982) and larger stentdiameter (OR=0.676,95%CI0.497-0.899).Conclusion：①The ISR has something to do with the diabetes, stnet length，stentdiameter，bifurcation lesion and serum total bilirubin level.②The risky factors leading tothe coronary in-stent restenosis tend to be the diabetes, stent length and bifurcation lesion.The higher level of serum total bilirubin concentration and larger stent diameter are twoprotective factors of coronary in-stent restenosis.