| ObjectiveThis study was designed to analyze the correlation between epicadial adipose tissue volume(EATV)and related inflammatory factors and in-stent restenosis(ISR)in patients with coronary heart disease after percutaneous coronary intervention(PCI),and to explore the predictive value of EATV and related inflammatory factors in ISR after PCI.MethodsA total of 407 patients with coronary heart disease who treated with drug-eluting stents in TEDA international cardiovascular disease hospital were enrolled from November 2016 to October 2017.Peripheral venous blood was collected early in the morning of the second day after admission,and the levels of interleukin-6(IL-6),hypersensitive c-reactive protein(Hs-CRP)and tumor necrosis factor(TNF-?)were detected.Measure EATV by multi-sclice CT(MSCT).Record the clinical data.Complete preoperative examination and eliminate coronary angiography contraindication.Arranging perform coronary angiography and PCI.Gensini score was performed according to the results of coronary angiography,and relevant data during stent implantation were recorded.Patients were divided into ISR group(n=52)and NISR group(n=355)according to ISR occurred within 1 year after procedure.SPSS 22.0 was used for data entry and statistical analysis,and P<0.05 was statistically significant.Results1.ISR group(n=52)and NISR group(n=355)had statistically significant differences in the history of diabetes(P<0.05),the prevalence of diabetes in ISR group was higher than that in NISR group(44.2%vs 23.9%,P=0.002),and other indicators were no statistically significant difference.2.The two groups had statistically significant differences in IL-6,TNF-?and EATV(P<0.05).The serum IL-6 level was higher in ISR group than in NISR group(141.18±32.79g/L vs 123.99±28.53g/L,P=0.001).The serum TNF-?level was higher in ISR group than in NISR group(149.95±20.62 g/L vs 132.89±22.58 g/L,P<0.001).The EATV level was a higher in ISR group than NISR group(146.92±35.50cm~3 vs 119.84±40.33 cm~3,P=0.001),and other indicators were no statistically significant difference.3.The two groups had statistically significant differences in bifurcation lesions,stent length and Gensini score(P<0.05).The rate of bifurcation lesions was higher in ISR group than in NISR group(23.1%vs 11.5%,P=0.021).The ISR group had longer stents than the NISR group(36.53±17.20mm vs 31.13±14.25mm,P=0.013),and the ISR group had a higher Gensini score than the NISR group(49.62±30.90 vs34.03±20.91,P=0.001).4.Multivariate logistic regression analysis showed that diabetes mellitus(OR=0.489,P=0.039),bifurcation lesions(OR=0.306,P=0.011),TNF-?(OR=1.022,P=0.041),Gensini score(OR=1.019,P=0.004)and EATV(OR=1.003,P=0.048)were risk factors for ISR.5.The ROC curve showed AUC of EATV was 0.712,95%CI:(0.648-0.776),P<0.001,when EATV was 116.61 cm~3(sensitivity was 86.5%,specificity was53.8%).The ROC curve showed AUC of TNF-?was 0.752,95%CI:(0.686-0.819),P<0.001,when TNF-?was 138.40 g/L(sensitivity was 67.3%,specificity was74.4%).Conclusion1.Diabetes,bifurcation,TNF-?,Gensini score,and EATV were risk factors for stent restenosis after PCI.2.EATV and TNF-?have certain predictive value for ISR after PCI,the combined diagnosis efficiency of the two is improved,which can be used as an indicator for clinical prediction of ISR.Provided a new therapeutic target for reducing the occurrence of ISR after PCI. |
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