| Objective: To investigate the correlative factors of in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with coronary heart disease(CHD),and to provide theoretical and practical basis for clinical practice.Methods:A total of 376 patients(corresponding to 516 target lesions)who were diagnosed as having coronary heart disease and undergoing PCI for the first time by coronary angiography(CAG)at the First Affiliated Hospital of Guangxi Medical University from January 2015 to December 2017 were collected.All patients were regularly returned to hospital after 8-12 months to complete CAG.According to the angiographic follow-up results,they were divided into restenosis group and non-restenosis group.The review of CAG results confirmed that coronary artery stenosis ?50% within 5 mm of stenting or stenting was defined as in-stent restenosis and classified as ISR group,and the others classified as non-ISR group.The related data(including general clinical data,relevant biochemical indicators,vascular status,and surgical data)were compared between the two groups,and the relationship between them and ISR was analyzed using single factor and Logistic multivariate analysis.Results:A total of 376 patients were enrolled,including 310 males and 66 females.The mean age was 59.52±9.81 years.In-stent restenosis occurred in 42 patients.The incidence of ISR was 11.17%.The statistical results were as follows:(1)General clinical data: There was no significant difference in gender,age,family history of CHD,and drinking history between the ISR group and the non-ISR group(P>0.05),but there were significant differences in the history of diabetes,hypertension,and smoking(P<0.05).(2)Related biochemical indicators: There was no significant difference in UREA,Creatinine(CREA),Total Cholesterol(TC),High-density Lipoprotein Cholesterol(HDL-C),Apolipoprotein A1(apoA1),Apolipoprotein B(apoB),Lipoprotein(a)[Lp(a)],Triglyceride(TG)and Homocysteine(HCY)between the ISR group and the non-ISR group(P>0.05),but there were significant differences in Total Bilirubin(TBiL),Uric Acid(UA),Low Density Lipoprotein Cholesterol(LDL-C),Fasting Blood Glucose(FBG),Hemoglobin Glycosylated(HbA1c),Fibrinogen(Fib)(P<0.05).(3)Lesion vascular status: There was no significant difference in the lesion site,lesion type,whether the bifurcation,occlusion,left main disease,and myocardial bridge(P>0.05),but there were significant differences in the number of preoperative coronary artery lesions and stenosis(P<0.05).(4)Surgical related data: There was no significant difference in the number of stents,pre-expansion,posterior expansion,and intravascular ultrasound(IVUS)guidance between ISR and non-ISR groups(P>0.05),but there were significant differences in whether the stent was implanted in series,the length of the implanted stent,and the diameter of the implanted stent(P<0.05).(5)Multivariate analysis: Logistic regression analysis revealed smoking history(OR=2.262,95% CI 1.006-6.088,P<0.05),preoperative stenosis(OR=1.072,95% CI 1.026-1.122,P<0.05).HbA1c(OR=1.413,95%CI 1.076-1.856,P<0.05),number of preoperative lesions(OR=1.899,95%CI 1.144-3.154,P<0.05)were positively correlated with the occurrence of ISR(P <0.05),while the diameter of implanted stent(OR=0.343,95%CI 0.123-0.959,P<0.05)was negatively correlated with the occurrence of ISR(P<0.05).Conclusions:(1)Coronary heart disease with smoking history,diabetes mellitus,preoperative vascular number,and severe coronary stenosis may be independent risk factors for in-stent restenosis,suggesting that cessation of smoking and strict control of blood glucose after stenting are beneficial to reduce the occurrence of stent restenosis.(2)The non-restenosis group had a larger stent diameter than the restenosis group.Implanting a larger diameter stent may be a protective factor for stent restenosis. |
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