scholarly journals Development and Validation of a Risk Prediction Nomogram for In- Stent Restenosis in Patients Undergoing Percutaneous Coronary Intervention

2021 ◽  
Author(s):  
Wenbo He ◽  
Changwu Xu ◽  
Xiaoying Wang ◽  
Jiyong Lei ◽  
Qinfang Qiu ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Regression Model ◽  
Coronary Intervention ◽  
Lasso Regression ◽  
Operating Characteristics ◽  
Stent Restenosis ◽  
Stent Type ◽  
Percutaneous Coronary ◽  
Development And Validation ◽  
In Stent Restenosis

Abstract Background: This study aimed to develop and validate a nomogram to predict probability of in-stent restenosis (ISR) in patients undergoing percutaneous coronary intervention (PCI). Methods: Patients undergoing PCI with drug-eluting stents between July 2009 and August 2011 were retrieved from a cohort study in a high-volume PCI center, and further randomly assigned to training and validation sets. The least absolute shrinkage and selection operator (LASSO) regression model was used to screen out significant features for construction of nomogram. Multivariable logistic regression analysis was applied to build a nomogram-based predicting model incorporating the variables selected in the LASSO regression model. The area under the curve (AUC) of the receiver operating characteristics (ROC), calibration plot and decision curve analysis (DCA) were performed to estimate the discrimination, calibration and utility of the nomogram model respectively.Results: A total of 463 patients with DES implantation were enrolled and randomized in the development and validation sets. The predication nomogram was constructed with five risk factors including prior PCI, hyperglycemia, stents in left anterior descending artery (LAD), stent type, and absence of clopidogrel, which proved reliable for quantifying risks of ISR for patients with stent implantation. The AUC of development and validation set were 0.706 and 0.662, respectively, indicating that the prediction model displayed moderate discrimination capacity to predict restenosis. The high quality of calibration plots in both datasets demonstrated strong concordance performance of the nomogram model. Moreover, DCA showed that the nomogram was clinically useful when intervention was decided at the possibility threshold of 9%, indicating good utility for clinical decision-making.Conclusions: The individualized prediction nomogram incorporating 5 commonly clinical and angiographic characteristics for patients undergoing PCI can be conveniently used to facilitate early identification and improved screening of patients at higher risk of ISR.

scholarly journals Development and validation of a risk prediction nomogram for in-stent restenosis in patients undergoing percutaneous coronary intervention

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenbo He ◽  
Changwu Xu ◽  
Xiaoying Wang ◽  
Jiyong Lei ◽  
Qinfang Qiu ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Regression Model ◽  
Clinical Decision Making ◽  
Coronary Intervention ◽  
Lasso Regression ◽  
Operating Characteristics ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
Development And Validation ◽  
In Stent Restenosis

Abstract Background This study aimed to develop and validate a nomogram to predict probability of in-stent restenosis (ISR) in patients undergoing percutaneous coronary intervention (PCI). Methods Patients undergoing PCI with drug-eluting stents between July 2009 and August 2011 were retrieved from a cohort study in a high-volume PCI center, and further randomly assigned to training and validation sets. The least absolute shrinkage and selection operator (LASSO) regression model was used to screen out significant features for construction of nomogram. Multivariable logistic regression analysis was applied to build a nomogram-based predicting model incorporating the variables selected in the LASSO regression model. The area under the curve (AUC) of the receiver operating characteristics (ROC), calibration plot and decision curve analysis (DCA) were performed to estimate the discrimination, calibration and utility of the nomogram model respectively. Results A total of 463 patients with DES implantation were enrolled and randomized in the development and validation sets. The predication nomogram was constructed with five risk factors including prior PCI, hyperglycemia, stents in left anterior descending artery (LAD), stent type, and absence of clopidogrel, which proved reliable for quantifying risks of ISR for patients with stent implantation. The AUC of development and validation set were 0.706 and 0.662, respectively, indicating that the prediction model displayed moderate discrimination capacity to predict restenosis. The high quality of calibration plots in both datasets demonstrated strong concordance performance of the nomogram model. Moreover, DCA showed that the nomogram was clinically useful when intervention was decided at the possibility threshold of 9%, indicating good utility for clinical decision-making. Conclusions The individualized prediction nomogram incorporating 5 commonly clinical and angiographic characteristics for patients undergoing PCI can be conveniently used to facilitate early identification and improved screening of patients at higher risk of ISR.

In vivo and in vitro analyses of the effects of a novel high-nitrogen low-nickel coronary stent on reducing in-stent restenosis

2018 ◽  
Vol 33 (1) ◽  
pp. 64-71 ◽  
Author(s):  
Jinpeng Wang ◽  
Chunli Song ◽  
Yanlong Xiao ◽  
Bin Liu
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Arteries ◽  
Coronary Intervention ◽  
Coronary Stent ◽  
High Nitrogen ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
In Stent Restenosis

Currently, percutaneous coronary intervention is an important treatment for coronary heart disease. However, the in-stent restenosis rate is still approximately 10–30% after stenting. Nickel ions from the stent are considered to be associated with in-stent restenosis. Therefore, in the present study, we quantitatively evaluated in-stent restenosis after implanting the novel high-nitrogen low-nickel coronary stent (HNS) and studied the mechanism underlying the reduction in in-stent restenosis by using ELISA and Western blot. The in vivo results showed that the HNS could significantly reduce neointima formation and inflammation as compared to SUS316L stents (316L) at 180 days after implantation in porcine coronary arteries and that vascular endothelial growth factor-A expression in porcine coronary arteries after HNS implantation also decreased. The in vitro results showed that, in the case of the HNS, human umbilical vein endothelial cell (HUVEC) proliferation was lower and lesser IL-6 release was noted from HUVECs at one and three days after culture than in the 316L group. Furthermore, p-STAT3 expression in HUVECs on the HNS surface was downregulated after culture for seven days. Thus, we conclude that the HNS could be a promising alternative coronary stent for percutaneous coronary intervention.

scholarly journals Effect of angiotensin converting enzyme gene polymorphism on patients with in-stent restenosis after percutaneous coronary intervention

2022 ◽  
Vol 20 (2) ◽  
pp. 403-409
Author(s):  
Tarek A. Abdelaziz ◽  
Randa H. Mohamed ◽  
Gehan F. Balata ◽  
Omar Y. El-Azzazy
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Angiotensin Converting Enzyme ◽  
Coronary Intervention ◽  
Converting Enzyme ◽  
Positive Interaction ◽  
Ace Gene ◽  
Stent Restenosis ◽  
Spin Column ◽  
Percutaneous Coronary ◽  
In Stent Restenosis

Purpose: To evaluate the association between common single nucleotide polymorphisms (SNPs) in angiotensin converting enzyme (ACE) gene and the risk of in-stent restenosis (ISR) and/or the response to angiotensin converting enzyme inhibitor ACEI in individuals with stable coronary artery disease (CAD) after stent implantation. Methods: The total population of this study consisted of 200 Egyptian individuals divided into 2 groups - in-stent restenosis (ISR) and non ISR group). Genomic DNA was withdrawn from EDTA whole blood applying a spin column approach and ACE gene insertion/deletion (I/D) polymorphisms were determined by polymerase chain reaction (PCR). Results: Carriers of allele D of ACE gene were significantly more liable to ISR occurrence. However, carriers of allele I were significantly more liable to ISR occurrence after administration of ACEI. There is a negative interaction between DD genotype of ACE gene and ACEI administration on ISR after percutaneous coronary intervention (PCI). However, there is a positive interaction between II and ID genotype of ACE gene and ACEI administration on ISR after PCI with bare metal stents (BMS). Conclusion: It is beneficial to implement ACEI in therapeutic regimen in individuals with ID or II genotypes of ACE gene, especially with BMS implementation.

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