Correlations Analysis Of Coronary Drug-eluting Stent Restenosis

Research objective. This study was performed to investigate the predictors of in-stent restenosis after percutaneous coronary intervention (PCI) with drug eluting stents (DES) in a consecutive series of patients and provide guidance to reduce the incidence rate of in-stent restenosis.Methods. We documented 125 patients(31 females,62.7±8.3years of age) with ACS undergoing successful implantation of coronary stents for de novo lesions from January 2012 to December 2014 in the Second Hospital of Shandong University.All patients received secondary coronary angiography at the mean one-year angiographic follow-up. They were classified into two groups including in-stent restenosis group (43 patients,11 females) and no in-stent restenosis group(82 patients,20 females) according to the results of follow-up angiography. Data were retrospectively collected, including baseline clinical features (gender, age, hypertension history, diabetes history, smoking history, drinking history blood biochemical indexes), anti-platelet medication (aspirin and clopidogrel), lesion characteristics, procedural variables and outcomes. Statistical analysis was performed with SPSS 18.0. The disorderly categorical variables were compared by chi-square test, the continuous variables were compared by Student’s t test, and the orderly categorical variables were compared by Mann-Whitney rank-sum test. For multivariate analysis, we performed a binary unconditioned logistic regression on the dependent variable.Results. The univariate analysis showed that,-hypertension (systolic and diastolic blood pressure), Diabetes Mellitus, HbAlc (glycated hemoglobin), TC (total cholesterol), LDL-C (low-density lipoprotein), anti-platelet medication, the degree of pathological changes, stent-implanting reason, stent position,stent diameter and stent length were statistically significant between two groups (P< 0.05).There were no statistical significances regarding gender, smoking history, drinking history, triglycerides (TC), HDL-C (high density lipoprotein), ApoAl (apolipoprotein A1), (apolipoprotein B), LP-a (lipoprotein a), and stent number between two groupsCP> 0.05). Furthermore, multivariate regression analysis revealed that,-hypertension, Diabetes Mellitus, LDL-C(low density lipoprotein), anti-platelet medication, multi-vessel lesions, implanting stents owing to UA(unstable angina), stent position, stent diameter, stent length etc were predictors of the incidence of in-stent restenosis (P<0.05).Conclusion. The poor control of blood pressure and blood sugar, lipid disorders (especially LDL-C), irregular anti-platelet medication after stent implantation, multi-vessel lesions, implanting stents owing to UA(unstable angina), stents implanted in LAD(left anterior decending vessel),long stents and small diameter stent etc were all risk factors of in-stent restenosis after PCI in patients with coronary heart disease.