Study On The Correlation Between The Controlled Blood Lipid Level And In-Stent Restenosis Of The Coronary Artery

Objective(s):To explore the correlation between the controlled blood lipid level and in-stent restenosis(ISR)which after patients with coronary heart disease(CHD)undergo percutaneous coronary intervention(PCI)for the first time.Methods:A total of 290 patients with coronary heart disease are treated with PCI for the first time,who admitted to the department of cardiology in the Second Affiliated Hospital of Kunming Medical University from Jan.2018 to Dec.2019.All patients were conventionally treated with oral dual antiplatelet and statins.And all patients returned to the hospital for coronary angiography from 3 months to 12 months after their PCI.According to the results of angiography,the patients were divided into ISR group and non-ISR group.Blood lipid levels before the first PCI and during the reexamination of angiography were compared between the two groups of patients,to investigate the relationship between the controlled blood lipid level and in-stent restenosis of coronary artery.Results:1.Overall situation:a total of 290 cases were selected,including 38 in the ISR group and 252 in the non-ISR group,with an ISR incidence of 13.1%.2.General comparison:The difference comparison for the age,gender,BMI,smoking,hypertension,yperuricemia,hyperhomocysteinemia between the two groups had no statistical significance(P>0.05),while comparing the type 2 diabetes mellitus difference between two groups had statistical significance(P<0.05),and the ratio of type 2 diabetes mellitus in patients of ISR group(47.37%)was higher than non-ISR group(25.40%).3.There was no statistically significant difference in TC,TG,HDL-C,LDL-C,non-HDL-C,LP(a)and ApoB levels between the ISR group and the non-ISR group before the first PCI(P>0.05).During the reexamination of angiography,the differences in TC,TG,1dl-c,non-hdl-c,LP(a)and ApoB levels between the two groups were statistically significant(P<0.05),while the the difference of HDL-C level was not statistically significant(P>0.05).The levels of TC,TG,LDL-C non-HDL-C,LP(a)and ApoB in the ISR group were higher than those in the non-ISR group.4.The differences in TG,HDL-C,LDL-C,non-HDL-C,LP(a),ApoB levels in the ISR group before the first PCI surgery and during the reexamination of angiography were statistically significant(P<0.05),the levels of TC,TG,LDL-C,non-HDL-C,LP(a),ApoB at the time of reexamination of angiography we're lower than those before the first PCI.However,there was no statistically significant difference in blood lipid level in the ISR group before PCI surgery and during reexamination of angiography(P>0.05).5.The cases were divided into 4 types:mixed hyperlipidemia,hypercholesterolemia,hypertriglyceridemia and low HDL-C hyperlipidemia according to the dyslipidemia during the reexamination of angiography.The differences in mixed hyperlipidemia and low HDL-C hyperlipidemia between the two groups were statistically significant(P<0.05),and the ratio of the ISR group was higher than those of the non-ISR group.6.The comparison of lipid controlling between the two groups showed that LDL-C was not up to the standard,TC did not decrease,TG did not decrease,HDL-C did not increase,non-HDL-C did not decrease,LP(a)did not decrease,and ApoB did not decrease,the differences were statistically significant(P<0.05).7.The logistic multivariate stepwise regression analysis of ISR showed that,after PCI surgery,type 2 diabetes mellitus(OR=2.865,95%CI 1.189?6.90,P<0.05),LDL-C(OR=2.952,95%CI 1.073?8.121,P<0.05)were not up to standard,HDL-C did not increase(OR=0.167,95%CI 0.063?0.443,P<0.05),and non-HDL-C increased(OR=5.940,95%CI 2.361?14.945,P<0.05).P<0.05),LP(a)increased(OR=8.429,95%CI 3.245?21.893,P<0.05),with the total stent length(OR=1.023,95%CI 1.005?1.041,P<0.05).Conclusion(s):1.Patients with type 2 diabetes mellitus have a significantly increased risk of ISR after PCI.2.After PCI,the high levels of TC,TG,LDL-C,non-HDL-C,LP(a)and ApoB were correlated with the ISR incidence3.After PCI,combined hyperlipidemia and/or low HDL-C hyperlipidemia have a higher probability of ISR incidence.4.After PCI,not standarded LDL-C,not increased HDL-C,increased non-HDL-C and LP(a)are the important risk factors for ISR incidence.