Application Of MSCT To Explore The Correlation Between In-stent Restenosis And Preoperative Coronary Artery Disease After PCI

Objectives 1 To explore the value of 256 multi-slice spiral computed tomography(MSCT)in the diagnosis of coronary heart disease.2 MSCT was used to retrospectively analyze the correlation between preoperative coronary artery lesions and in-stent restenosis(ISR)in patients undergoing percutaneous coronary intervention(PCI).Methods 1 From October 2017 to March 2018,68 patients(204 main vessels)with coronary artery disease were examined by coronary artery computed tomography angiography(CCTA)and coronary artery angiography(CAG)in the Affiliated Hospital of North China University of Technology.According to the degree of coronary artery stenosis,the patients were divided into two groups: negative group(stenosis less than 50%)and positive group(stenosis more than 50%).The sensitivity,specificity,positive predictive value,negative predictive value,diagnostic accuracy and Kappa value of 256 MSCT in the diagnosis of coronary heart disease were analyzed with the results of CAG as the gold standard.2 215 patients with PCI,CCTA before operation and CAG after operation in the Affiliated Hospital of North China University of Technology from January 2015 to January2019 were divided into two groups according to the results of CAG examination: ISR group and non-ISR group.The clinical data and biochemical data of the two groups were collected.The characteristics of coronary plaque,the length of coronary artery stenosis and coronary artery disease of the two groups were analyzed.The risk factors of ISR in patients with coronary heart disease after PCI were analyzed,including the degree of stenosis,the number of coronary artery lesions and the location of coronary artery lesions.Results 1 By comparing the general data of the two groups,it was found that there was no significant difference in gender,age and heart rate between the negative group and the positive group(P>0.05).A total of 204 vessels were studied in 68 cases,of which 199 were available for evaluation.The sensitivity,specificity,positive predictive value and negative predictive value of CCTA were 83.33%,95.86%,88.23%,93.91%,92.46%,Kappa = 0.806,P<0.05.2 By comparing the general data and biochemical data of the two groups,it was found that the patients in ISR group and non-ISR group had sex,age,body mass index,hypertension,diabetes mellitus,hyperlipidemia,smoking history,family history,blood sugar,total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),There was no significant difference(P>0.05).Patch nature: 15 non-calcified plaques(53.57%,15/28),11 mixed plaques(39.29%,11/28),2 calcified plaques(7.14%,2/28)in ISR group,48 noncalcified plaques(23.53%,48/204),40 mixed plaques(19.61%,40/204),116 calcified plaques(56.86%,116/204)in non-ISR group,the difference was statistically significant(P<0.05).Length of lesion stenosis: The length of lesion stenosis before operation in ISR group and non-ISR group were(20.91±8.38)mm and(17.04±8.30)mm,respectively,with significant difference(P<0.05).Stenosis degree: The average stenosis degree before operation in ISR group and non-ISR group was(87.63 ±7.42)% and(84.91±7.44)%.There was no significant difference(P>0.05).The number of lesion branches: single vessel lesions in 10 cases(38.46%,10/26),double vessel lesions in 7 cases(26.92%,7/26),three vessel lesions in 9 cases(34.62%,9/26),single vessel lesions in 77 cases(40.74%,77/189),double vessel lesions in 50 cases(26.46%,50/189),and three vessel lesions in 62 cases(32.80%,62/189)in ISR group had no significant difference(P>0.05).Lesion sites: In ISR group,the lesion sites were located in right coronary artery(RCA)in 7 cases(26.92%,7/26),left anterior descending(LAD)in 15 cases(57.69%,15/26),left circumflex(LCX)in 4 cases(15.39%,4/26),and in non-ISR group,RCA in 80 cases(42.33%,80/189),LAD in 62 cases(32.80%,62/189),LCX in 47 cases.(24.87%,47/189),the difference was significant(P<0.05).Multiple logistic regression analysis showed that the occurrence of ISR and non-calcified plaque(? = 1.835,S.E.=0.843,Wald ?2= 4.726,P = 0.030,OR =6.267,95% CI was 1.198~8.156),mixed plaque(?= 1.056,S.E.= 0.448,Wald ?2=5.557,P= 0.018,OR = 2.874,95% CI was 1.033~5.914),Stenosis length(?=0.089,S.E.=0.041,Wald ?2= 4.671,P = 0.031,OR = 1.093,95% CI was 1.008~1.186)may be a high risk factor for ISR.Conclusions 1 MSCT has high clinical diagnostic value in the diagnosis of coronary heart disease.2 The occurrence of ISR is related to the nature of plaque,the location of lesion and the length of lesion before operation.3 Non-calcified plaque,mixed plaque and lesion length may be risk factors for ISR.Figure2;Table11;Reference 162...