Novel Biomarkers for Coronary Restenosis Occurrence After Drug-Eluting Stent Implantation in Patients With Diabetes Having Stable Coronary Artery Disease.
Novel Biomarkers for Coronary Restenosis Occurrence After Drug-Eluting Stent Implantation in Patients With Diabetes Having Stable Coronary Artery Disease.
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DOI：
10.1177/1076029618771752
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发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Smirnov V
中科院分区：
文献类型：
--
作者：
Gabbasov Z;Kozlov S;Melnikov I;Byazrova S;Saburova O;Prokofieva L;Caprnda M;Curilla E;Gaspar L;Rodrigo L;Kruzliak P;Smirnov V
本研究的目的是评估2型糖尿病（DM）患者植入药物洗脱支架（DES）治疗稳定性冠状动脉疾病（CAD）后再狭窄的发生是否与CD 45+血小板计数和中性粒细胞/淋巴细胞比值相关。该研究包括126名患者，其中55名2型糖尿病和稳定型CAD患者接受了DES选择性冠状动脉支架植入术，并在6至12个月内进行了随访血管造影。在冠状动脉造影术的早晨从每名患者中采集血液样本。Logistic回归分析筛选与支架内再狭窄相关的变量。Logistic回归分析显示，2项炎症因子、CD 45+血小板计数（比值比[OR] = 4.51，95%置信区间[CI]：1.50-13.50，P = .007）和中性粒细胞/淋巴细胞比值（OR = 3.09，95% CI：1.05-9.10，P = 0.04）与稳定型CAD和2型DM患者DES支架植入术后支架内再狭窄的风险显著相关。受试者操作特征曲线分析表明，曲线下面积为0.83%（0.05%; P < .001），这表明logistic模型对CAD和2型糖尿病患者DES支架内再狭窄风险具有良好的预测准确性（基于CD 45+血小板计数和中性粒细胞/淋巴细胞比值）。两种新的再狭窄生物标志物，CD 45+血小板计数和中性粒细胞与淋巴细胞比率，可有效地用于预测CAD和2型糖尿病患者DES植入后支架内再狭窄。
The purpose of the study was to assess whether the occurrence of restenosis is associated with CD45+ platelet count and neutrophil to lymphocyte ratio in patients with type 2 diabetes mellitus (DM) after drug-eluting stent (DES) implantation for stable coronary artery disease (CAD). The study comprised 126 patients, including 55 patients with type 2 DM and stable CAD who underwent elective coronary artery stenting with DES and follow-up angiography within 6 to 12 months. Blood samples were collected from each patient on the morning of the coronary angiography procedure. The variables related to in-stent restenosis were selected by logistic regression analysis. The logistic regression analysis showed that 2 inflammatory factors, CD45+ platelet count (odds ratio [OR] = 4.51, 95% confidence interval [CI]: 1.50-13.50, P = .007) and neutrophil to lymphocyte ratio (OR = 3.09, 95% CI: 1.05-9.10, P = .04), were significantly associated with the risk of in-stent restenosis after stenting with DES in patients with stable CAD and type 2 DM. A receiver operator characteristic curve analysis indicated that the area under the curve was 0.83% (0.05%; P < .001), which showed that the logistic model had good predictive accuracy (based on CD45+ platelet count and neutrophil to lymphocyte ratio) for the risk of in-stent restenosis development in DES in patients with CAD and type 2 DM. Two novel biomarkers of restenosis, CD45+ platelet count and neutrophil to lymphocyte ratio, may be effectively used to predict in-stent restenosis after DES implantation in patients with CAD and type 2 DM.
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