scholarly journals A prediction model based on platelet parameters, lipid levels, and angiographic characteristics to predict in-stent restenosis in coronary artery disease patients implanted with drug-eluting stents

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Min-Tao Gai ◽  
Bing Zhu ◽  
Xiao-Cui Chen ◽  
Fen Liu ◽  
Xiang Xie ◽  
...  
Keyword(s):  
Prediction Model ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Distribution Width ◽  
Model Based ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

Abstract Background The present study was aimed to establish a prediction model for in-stent restenosis (ISR) in subjects who had undergone percutaneous coronary intervention (PCI) with drug-eluting stents (DESs). Materials and methods A retrospective cohort study was conducted. From September 2010 to September 2013, we included 968 subjects who had received coronary follow-up angiography after primary PCI. The logistic regression analysis, receiver operator characteristic (ROC) analysis, nomogram analysis, Hosmer–Lemeshow χ2 statistic, and calibration curve were applied to build and evaluate the prediction model. Results Fifty-six patients (5.79%) occurred ISR. The platelet distribution width (PDW), total cholesterol (TC), systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and lesion vessels had significant differences between ISR and non-ISR groups (all P < 0.05). And these variables were independently associated with ISR (all P < 0.05). Furthermore, they were identified as predictors (all AUC > 0.5 and P < 0.05) to establish a prediction model. The prediction model showed a good value of area under curve (AUC) (95%CI): 0.72 (0.64–0.80), and its optimized cut-off was 6.39 with 71% sensitivity and 65% specificity to predict ISR. Conclusion The incidence of ISR is 5.79% in CAD patients with DES implantation in the Xinjiang population, China. The prediction model based on PDW, SBP, TC, LDL-C, and lesion vessels was an effective model to predict ISR in CAD patients with DESs implantation.

scholarly journals Inverse Relationship between Serum VEGF Levels and Late In-Stent Restenosis of Drug-Eluting Stents

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Jiasheng Yin ◽  
Li Shen ◽  
Meng Ji ◽  
Yizhe Wu ◽  
Sishi Cai ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Pathological Process ◽  
Drug Eluting Stents ◽  
Stent Restenosis ◽  
Significant Difference ◽  
Drug Eluting ◽  
Endothelial Growth Factor ◽  
In Stent Restenosis

Late in-stent restenosis (ISR) has raised concerns regarding the long-term efficacy of drug-eluting stents (DES). The role of vascular endothelial growth factor (VEGF) in the pathological process of ISR is controversial. This retrospective study aimed to investigate the relationship between serum VEGF levels and late ISR in patients with DES implantation. A total of 158 patients who underwent angiography follow-up beyond 1 year after intervention were included. The study population was classified into ISR and non-ISR groups. The ISR group was further divided according to follow-up duration and Mehran classification. VEGF levels were significantly lower in the ISR group than in the non-ISR group [96.34 (48.18, 174.14) versus 179.14 (93.59, 307.74) pg/mL, p<0.0001]. Multivariate regression revealed that VEGF level, procedure age, and low-density lipoprotein cholesterol were independent risk factors for late ISR formation. Subgroup analysis demonstrated that VEGF levels were even lower in the very late (≥5 years) and diffuse ISR group (Mehran patterns II, III, and IV) than in the late ISR group (1–4 years) and the focal ISR group (Mehran pattern I), respectively. Furthermore, significant difference was found between diffuse and focal ISR groups. Serum VEGF levels were inversely associated with late ISR after DES implantation.

scholarly journals Vascular responses to coronary calcification following implantation of newer-generation drug-eluting stents in humans: impact on healing

2019 ◽  
Vol 41 (6) ◽  
pp. 786-796 ◽  
Author(s):  
Sho Torii ◽  
Hiroyuki Jinnouchi ◽  
Atsushi Sakamoto ◽  
Hiroyoshi Mori ◽  
Joohyung Park ◽  
...  
Keyword(s):  
Independent Predictor ◽  
Coronary Calcification ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Vascular Responses ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
In Stent Restenosis ◽  
Severe Calcification

Abstract Aims Vascular calcification is routinely encountered in percutaneous coronary intervention (PCI) and severe coronary calcification is a known predictor of in-stent restenosis and stent thrombosis. However, the histopathologic mechanisms behind such events have not been systematically described. Methods and results From our registry of 1211 stents, a total of 134 newer-generation drug-eluting stents (DES) (Xience, Resolute-Integrity, PROMUS-Element, and Synergy) with duration of implant ≥30 days were histologically analysed. The extent of calcification of the stented lesions was evaluated radiographically and divided into severe (SC, n = 46) and non-severely calcified lesions (NC, n = 88). The percent-uncovered struts per section {SC vs. NC; median 2.4 [interquartile range (IQR) 0.0–19.0] % vs. 0.0 (IQR 0.0–4.6) %, P = 0.02} and the presence of severe medial tears (MTs) (59% vs. 44%, respectively, P = 0.03) were greater in SC than NC. In addition, SC had a higher prevalence of ≥3 consecutive struts lying directly in contact with surface calcified area (3SC) (52% vs. 8%, respectively, P &lt; 0.0001). Multivariate analysis demonstrated that sections with duration of implantation ≤6 months [odds ratio (OR): 7.7, P &lt; 0.0001], 3SC (OR: 6.5, P &lt; 0.0001), strut malapposition (OR: 5.0, P &lt; 0.0001), and lack of MTs (OR: 2.5, P = 0.0005) were independent predictors of uncovered struts. Prevalence of neoatherosclerosis was significantly lower in SC than that of NC (24% vs. 44%, P = 0.02). Conclusion Severe calcification, especially surface calcified area is an independent predictor of uncovered struts and delayed healing after newer-generation DES implantation. These data expand of knowledge of the vascular responses of stenting of calcified arteries and suggests further understand of how best to deal with calcification in patients undergoing PCI.

scholarly journals Impact of anemia on in-stent restenosis after percutaneous coronary intervention

2021 ◽  
Author(s):  
Huilin Hu ◽  
Shijun Wang ◽  
Guanmin Tang ◽  
Changlin Zhai ◽  
Liang Shen
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Low Density Lipoprotein ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Logistic Analysis ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
Stent Diameter ◽  
In Stent Restenosis

Abstract Background Anemia is a well-recognized risk factor for adverse events after percutaneous coronary intervention (PCI), but data regarding the association between anemia and in-stent restenosis (ISR) remain limited.Methods A total of 538 patients who underwent PCI between January 2018 and September 2019 and performed follow-up angiography 9–12 months after the initial PCI was enrolled in the study. Baseline clinical and procedural characteristics were compared between ISR and non-ISR group. Multivariate logistic regression analysis was employed to determine the independent predictors of ISR.Results The incidence of anemia in patients with ISR was 53.5% and 19.0% in the non-ISR group, which was significantly different (P ༜0.001). The rate of diabetes, chronic kidney disease (CKD), bifurcation lesion and calcification was significantly higher in ISR group. In addition, low-density lipoprotein cholesterol (LDL-c), multiple stenting and stent diameter were also significantly related with ISR. After multivariate logistic analysis, anemia (odds ratio [OR], 2.786; 95% confidence interval [CI], 1.091 to 7.115; P = 0.032) together with LDL-c (OR, 1.682; 95% CI, 1.145 to 2.469; P = 0.008), diabetes (OR, 3.582; 95% CI, 1.406 to 9.125; P = 0.007), CKD (OR, 2.841; 95% CI, 1.006 to 8.027; P = 0.049), multiple stenting (OR, 2.823; 95% CI, 1.184 to 6.731; P = 0.019), and stent diameter (OR, 2.778; 95% CI, 1.069 to 7.194; P = 0.036) were closely associated with ISR.Conclusion Anemia is closely associated with ISR after PCI, patients with lower hemoglobin have a higher risk of ISR.

scholarly journals A Case of Very Early Stent Restenosis Following DES Implantation

2019 ◽  
Vol 04 (04) ◽  
pp. 200-203 ◽  
Author(s):  
Shravan Kumar Ch ◽  
Naveen Kumar M. ◽  
Sudhakar Kanumuri
Keyword(s):  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Drug Eluting Stents ◽  
Metal Stents ◽  
Bare Metal ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
In Stent Restenosis ◽  
Stent Stenosis

AbstractIntracoronary in-stent restenosis (ISR) is more common with bare metal stents. With the introduction of drug-eluting stents (DESs), the incidence of ISR has markedly decreased. Here, we report a case of unusual very early stent restenosis in a patient who presented with unstable angina 15 days after percutaneous coronary intervention with sirolimus-eluting DES. Optical coherence tomography (OCT) was done to know the pathophysiology of the very early stent stenosis and the possibilities of the rare findings of this OCT are discussed.

scholarly journals Impact of anemia on in-stent restenosis after percutaneous coronary intervention

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huilin Hu ◽  
Shijun Wang ◽  
Guanmin Tang ◽  
Changlin Zhai ◽  
Liang Shen
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Coronary Intervention ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
Stent Diameter ◽  
In Stent Restenosis

Abstract Background Anemia is a common risk factor for post-percutaneous coronary intervention (PCI) adverse events; however, data on its association with in-stent restenosis (ISR) is limited. Methods 538 patients who underwent PCI between January 2017 and September 2019 and follow-up angiography 9–12 months after the initial PCI were enrolled in this study. Baseline clinical and procedural characteristics were compared between the ISR and non-ISR groups, and independent predictors of ISR were determined using propensity score matching. Results The incidence of anemia was 53.5% in patients with ISR and 19.0% in those without ISR. Univariable logistic regression analyses showed that anemia (OR, 4.283; 95% CI, 1.949–9.410; P < 0.001), diabetes mellitus (OR, 2.588; 95% CI, 1.176–5.696; P = 0.018), chronic kidney disease (OR, 3.058; 95% CI, 1.289–7.252; P = 0.011), multiple stenting (OR, 2.592; 95% CI, 1.205–5.573; P = 0.015), bifurcation lesion (OR, 2.669; 95% CI, 1.236–5.763; P = 0.012), and calcification (OR, 3.529; 95% CI, 1.131–11.014; P = 0.030) were closely associated with ISR. Low-density lipoprotein cholesterol (LDL-c) levels and stent diameter were also significantly linked to ISR, as was anemia (P = 0.009) after propensity score matching. Conclusion Anemia is closely associated with post-PCI ISR, and patients with lower hemoglobin levels are at a higher risk of ISR.

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