Primary Study On The Risk Factors Of Recurrent Restenosis After Paclitaxel-coated Balloon Angioplasty For Coronary Heart Disease

Objective:The purpose of this study is to analyze clinical data of patients with coronary heart disease after paclitaxel-coated balloon angioplasty,discover the risk factors of the binary restenosis.Methods: This observational study enrolled a total of 77 patients with coronary heart disease after paclitaxel-coated balloon angioplasty confirmed by coronary angiography in the First Affiliated Hospital of Jinan University or Nanfang Hospital,Guangzhou,China between January2016 and June 2019,included in-stent restenosis,small vessels disease,bifurcation lesions and de novo coronary lesions.Patients were divided into non-binary restenosis group and binary restenosis group according to results of repeated angiography after 6 months.The clinical parameters of these patients were analyzed by univariate analysis and unconditioned logistic regession analysis,discover the risk factors of the binary restenosis.Univariate and multivariate Cox regression were performed to discover independent risk factors of MACE.Kaplan-Meier survival curves were used to compare the MACE-free rate between the two groups.Results:A total of 77 patients with coronary heart disease after paclitaxel-coated balloon angioplasty were included in final analysis,binary restenosis rate was found to be 50.65%(39 of77 patients)after 6 months.One-year MACE rate was found to be 38.96%(30 of 77patients).Unconditioned logistic regession analysis revealed that residual stenosis(OR:1.113,95%CI:1.059-1.171,P=0.000),renal insufficiency(OR:4.279,95%CI:1.092-16.760,P=0.037)and DCB diameter<3mm(OR:4.005,95%CI:1.110-14.452,P=0.034)were risk factors of the binary restenosis.Multivariate Cox regression analysis showed that hemodialysis(HR:1.036,95%CI:1.004-1.068,P=0.026),Gensini score(HR:1.014,95%CI:1.005-1.023,P=0.003)and age(HR:1.036,95%CI:1.004-1.068,P=0.026)were independently correlated with the occurrence of MACE.Kaplan-Meier survival analysis demonstrated that patients in thebinary restenosis group had a higher rate of MACE compared with those in the non-binary restenosis group during one-year follow-up period,but the difference was not statistically significant(Log-rank P=0.434).Conclusion:1.Our study demonstrates that residual stenosis,renal insufficiency and DCB diameter<3mm are meaningful risk factors of the binary restenosis in patients with coronary heart disease after 6-month paclitaxel-coated balloon angioplasty.2.Hemodialysis,Gensini score and age are thought to be very likely independent risk factors of MACE within 1-year follow-up.