Relationship Between Blood Lipid Management And In-stent Restenosis After Drug-eluting Stent Implantation In Patients With Coronary Heart Disease

Objective: To explore the relationship between the lipid management and the incidence of ISR by analyzing the initial blood lipid levels,lipid review levels and the degree of reduction or elevation in the two groups(ISR group and non-ISR group).Methods: Patients who was firstly implanted DES in the Center for Diagnosis and Treatment of Cardiovascular Diseases at the First Hospital of Jilin University and then reviewed angiography from January 1,2016 to December 31,2016 were involved in this analysis.According to the results of the latest angiography,they were divided into two groups.Then analyze the demographic characteristics,clinical history data,blood biochemistry and echocardiographic indicators,coronary lesion characteristics,stent status,and postoperative drug use in both groups.The statistically significant differences between the two groups were included in multivariate logistic regression analysis.Results:1 A total of 427 cases were enrolled,76 in the ISR group and 351 in the non-ISR group.The incidence of ISR in selected cases was 17.8%.2 There was no significant difference in the comparison of general conditions between two groups among age,gender,smoking,history of hypertension and its control,history of myocardial infarction,history of stroke,family history of coronary heart disease,history of diabetes,acute coronary syndrome diagnosis,stent thrombosis and the left ventricular ejection fraction(P>0.05).3 The reviewing TC level and non HDL-C level in the ISR group were higher than those in the non-ISR group,and the reduction rate of non HDL-C/HDL-C ratio was lower than that in the non-ISR group.(P<0.05).The reviewing creatinine level between the two groups was within the normal range,but the creatinine level in the ISR group was higher than that in the non-ISR group.There was a statistically significant difference between the two groups(P<0.05).4 There were more diffuse coronary lesions and stents in ISR group than non-ISR group.The total stent length was longer than non-ISR group.There were significant differences in the three factors between the two groups(P< 0.05).5 The ISR group had longer stent placement time and there were more irregular statins therapies in the ISR group(P<0.05).6 Multivariate logistic regression analysis showed that elevated or unchanged reviewing total cholesterol levels,irregular statin lipid-lowering drugs,increased serum creatinine,and long coronary stent placement were independently associated with ISR(P<0.05).Conclusion:1 The higher or unchanged TC reexamination level and irregular statin medication taking are risk factors for ISR,suggesting the potential for good management of blood lipid levels to prevent the occurrence of ISR.2 The increased reviewing serum creatinine is a risk factor for ISR.3 The length of coronary stent placement is related to the occurrence of ISR.