Relationship between Lp-PLA2 and in-stent restenosis after coronary stenting: a 3-year follow-up study

2021 ◽  
pp. 003693302110348
Author(s):  
Guohua Sheng ◽  
Juan Zhou ◽  
Chi Zhang ◽  
Caijuan Wu ◽  
Kairong Huang ◽  
...  
Keyword(s):  
Coronary Intervention ◽  
Risk Indicators ◽  
Major Adverse Cardiovascular Events ◽  
Stent Restenosis ◽  
Kaplan Meier ◽  
Early Restenosis ◽  
Late Restenosis ◽  
The Relationship ◽  
In Stent Restenosis

Background and aims Coronary in-stent restenosis (ISR) is an important complication of percutaneous coronary intervention (PCI). However, the relationship between lipoprotein associated phospholipase A2 (Lp-PLA2) level and ISR after PCI is rarely reported. This study aims to explore the relationship between Lp-PLA2 and the occurrence of ISR at post-PCI and its predictive value for ISR. Methods and results Plasma Lp-PLA2 mass were measured in 847 patients planting 1262 stents and evaluated along with known risk indicators. One-year angiographic follow-up showed that baseline elevated Lp-PLA2 mass was strongly associated with early restenosis (95% CI = 1.062-3.050, P < 0.05). Beyond the first year, the occurrence of late restenosis (95% CI = 1.043-3.214, P < 0.05) was significantly larger in the elevated Lp-PLA2 group. Kaplan-Meier analysis after three-year clinical follow up suggested that Lp-PLA2 mass did add the positive effect on the occurrence of major adverse cardiovascular events (MACEs). Conclusion In conclusion, increased baseline plasma Lp-PLA2 predicts increased risks of re-stenosis and MACEs, which may be a novel biomarker for predicting ISR and MACEs.

scholarly journals D-Dimer to Fibrinogen Ratio as a Novel Prognostic Marker in Patients After Undergoing Percutaneous Coronary Intervention: A Retrospective Cohort Study

2020 ◽  
Vol 26 ◽  
pp. 107602962094858
Author(s):  
Yan Bai ◽  
Ying-Ying Zheng ◽  
Jun-Nan Tang ◽  
Xu-Ming Yang ◽  
Qian-Qian Guo ◽  
...  
Keyword(s):  
Cox Regression ◽  
Coronary Intervention ◽  
Diagnosis And Prognosis ◽  
Kaplan Meier ◽  
Percutaneous Coronary ◽  
The Relationship ◽  
D Dimer

The role of activation of the coagulation and fibrinolysis system in the pathogenesis and prognosis of cardiovascular diseases (CVDs) has drawn wide attention. Recently, the D-dimer to fibrinogen ratio (DFR) is considered as a useful biomarker for the diagnosis and prognosis of ischemic stroke and pulmonary embolism. However, few studies have explored the relationship between DFR and cardiovascular disease. In our study, patients were divided into 2 groups according to DFR value: the lower group (DFR < 0.52, n = 2123) and the higher group (DFR ≥ 0.52, n = 1073). The primary outcome was all-cause mortality (ACM) and cardiac mortality (CM). The average follow-up time was 37.59 ± 22.24 months. We found that there were significant differences between the 2 groups in term of ACM (2.4% vs 6.6%, P < 0.001) and CM (1.5% vs 4.0%, P < 0.001). Kaplan–Meier analyses showed that elevated DFR had higher incidences of ACM (log rank P < 0.001) and CM (log rank P < 0.001). Multivariate Cox regression analyses showed that DFR was an independent predictor of ACM (HR = 1.743, 95%CI: 1.187-2.559 P = 0.005) and CM (HR = 1.695, 95%CI: 1.033-2.781 P = 0.037). This study indicates that DFR is an independent and novel predictor of long-term ACM and CM in post-PCI patients with CAD.

scholarly journals Stent strut ablation with rotational atherectomy device (Rotablator™) for restenosis treatment. Analysis and late follow-up

2020 ◽  
pp. 1-6
Author(s):  
Débora Rocha ◽  
Henrique Guimarães ◽  
Flávio Barbosa ◽  
Álvaro Morais Júnior ◽  
Roosevelt Diniz ◽  
...  
Keyword(s):  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Rotational Atherectomy ◽  
Metal Stents ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
Stent Strut ◽  
In Stent Restenosis

The widespread use of bare metal stents as from 1995 led to the appearance of a new entity called in-stent restenosis, and the severe concomitant calcification of the vessels is a challenge for the interventional cardiologist. In this scenario, rotational atherectomy has rised as a therapeutic rescue approach to manage this situation, using trephines to eliminate the underexpanded and non-expandable coronary stents. However, comprehensive data on the long-term efficacy or results of the procedures have not been published yet. We report a case of rotational atherectomy in stent restenosis, followed by percutaneous coronary intervention with implantation of a new stent to treat a calcified in-stent lesion.

P5614The association between tissue morphology assessed with optical coherence tomography and mid and late-term results after percutaneous coronary intervention for in-stent restenosis lesions

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Tada ◽  
K Miura ◽  
M Ohya ◽  
T Shimada ◽  
R Murai ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Midterm Results ◽  
Fibrous Plaque ◽  
Tissue Morphology ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
In Stent Restenosis

Abstract Background It was reported that tissue morphology of in-stent restenosis (ISR) lesions assessed with optical coherence tomography (OCT) had an effect on midterm results including ISR and target lesion revascularization (TLR) rates after percutaneous coronary intervention (PCI). However, little was known about the association between tissue morphology assessed with OCT and late-term results. Methods We performed PCI treated with paclitaxel coated balloon (PCB) or drug-eluting stent (DES) for 452 ISR lesions (260 lesions with fibrous plaque and 192 lesions with lipid-laden plaque) using OCT between May 2008 and July 2016. Six- to eight-month (midterm) angiographic follow-up was performed on 422 of the 452 ISR lesions (follow-up rate: 93.4%). Furthermore, eighteen- to twenty-month (late-term) angiographic follow-up was performed on 337 of the 361 ISR lesions (follow-up rate: 93.4%) which were free from midterm TLR. We examined the association between tissue morphology, midterm-results and late-term results including ISR and TLR rates. Fibrous plaque was defined as homogeneous, signal-rich regions with low attenuation. Lipid-laden plaque was defined as diffuse border, signal poor regions with high attenuation. Results The patients were 353 men and 69 women, and the mean age was 68.8±9.6 years. PCI were performed with PCB in 285 lesions (PCB group) and DES in 137 lesions (DES group). The figure shows the angiographic midterm results of the 422 lesions and late-term results of the 337 lesions with respect to each tissue morphology and each PCI device. There was no difference in ISR and TLR rates of lesions with both fibrous and lipid-laden plaque at midterm between the two groups. ISR and TLR rates of lesions with lipid-laden plaque at late-term were significantly higher in the PCB group than in the DES group, while there was no difference in ISR and TLR rates of lesions with fibrous plaque at late-term between two groups. Figure 1 Conclusion Tissue morphology of ISR lesions might have an impact on outcomes after PCI. Morphological assessment of ISR tissue using OCT might suggest favorable types of PCI for ISR lesions.

scholarly journals Apolipoprotein C3 and Necrotic Core Volume Are Correlated but Also Associated With Future Cardiovascular Events

2022 ◽  
Author(s):  
Takayuki Ohwada ◽  
Takayuki Sakamoto ◽  
Satoshi Suzuki ◽  
Yukiko Sugawara ◽  
Kazuhiko Nakazato ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Coronary Intervention ◽  
Necrotic Core ◽  
Laboratory Evaluation ◽  
Major Adverse Cardiovascular Events ◽  
Apolipoprotein C3 ◽  
Kaplan Meier ◽  
Percutaneous Coronary ◽  
The Relationship ◽  
Core Volume

Abstract We aimed to clarify the relationship between apolipoprotein C3 (apo-C3) and vascular composition of lesion plaque in stable coronary disease (SCD) before percutaneous coronary intervention (PCI) and to investigate major adverse cardiovascular events (MACEs) within 4 years. Data of 98 consecutive patients with SCD who underwent PCI between November 1, 2012, and March 10, 2015, were analyzed. Laboratory evaluation and virtual histology-intravascular ultrasound (VH-IVUS) examination of culprit lesions were conducted before PCI. Patients were divided according to the median apo-C3 value into low apo-C3 (≤8.5 mg/dL) and high apo-C3 (>8.5 mg/dL) groups. VH-IVUS data indicated that the percentage of necrotic core volume (%NC) was significantly higher in the high apo-C3 group than in the low apo-C3 group. Moreover, the %NC significantly correlated with the apo-C3 level (R=0.2109, P=0.037). Kaplan–Meier curve analysis revealed that freedom from MACEs decreased more in the high apo-C3 group than in the low apo-C3 group and in the high %NC group than in the low %NC group. Multivariate Cox hazards analysis showed that the %NC and high apo-C3 were independent predictors of 4-year MACEs. Apo-C3 may be a useful marker for future MACEs in patients with SCD after PCI and contribute to %NC growth.

scholarly journals Visit-to-Visit HbA1c Variability is Associated with In-Stent Restenosis in Patients with Type 2 Diabetes after Percutaneous Coronary Intervention

2020 ◽  
Author(s):  
Chen Die Yang ◽  
Ying Shen ◽  
Lin Lu ◽  
Zhen Kun Yang ◽  
Jian Hu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Stent Implantation ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
The Mean ◽  
In Stent Restenosis

Abstract Background: Patients with type 2 diabetes are under substantially higher risk of in-stent restenosis (ISR) after coronary stent implantation. We sought to investigate whether visit-to-visit HbA1c variability is a potential predictor of ISR in diabetic patients after stent implantation.Methods: We consecutively enrolled type 2 diabetic patients who underwent successful elective percutaneous coronary intervention and performed follow-up coronary angiography after around 12 months. The incidence of ISR and its relationship with visit-to-visit HbA1c variability, expressed as coefficient of variation (CV), standard deviation (SD) and variability independent of the mean (VIM), were studied. Multivariable Cox proportional hazards models were constructed to analyze the predictive value of HbA1c variability for ISR.Results: From September 2014 to July 2018 in Ruijin Hospital, a total of 420 diabetic patients (688 lesions) after stent implantation were included in the final analysis. During a mean follow-up of 12.8±1.3 months, the incidence of ISR was 8.6%, which was significantly increased in patients with higher CV of HbA1c (P=0.001). The mean diameter stenosis (DS), net luminal loss and net luminal gain were 22.9±16.8%, 0.42±0.88 mm and 1.66±0.83 mm, respectively. Greater DS was observed in subjects with higher tertiles of CV of HbA1c (P<0.001), and this trend was more prominent in patients with optimal glycemic control (HbA1c≤7%) in the baseline. In multivariate analysis, HbA1c variability was independently associated with incidence of ISR after adjustment for traditional risk factors and mean HbA1c (HR: 3.00 [95% CI:1.14~7.92] for highest vs. lowest tertile). Inclusion of CV of HbA1c led to a better risk stratification accuracy. Assessing HbA1c variability by SD or VIM yielded similar findings. Conclusions: This study suggests that visit-to-visit HbA1c variability is an independent predictor of incidence of ISR in patients with type 2 diabetes after stent implantation.Trial registration: Trials number, NCT02089360; registered on March 17,2014.

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