Evaluation of Preprocedural Laboratory Parameters as Predictors of Drug-Eluting Stent Restenosis in Coronary Chronic Total Occlusion Lesions
Evaluation of Preprocedural Laboratory Parameters as Predictors of Drug-Eluting Stent Restenosis in Coronary Chronic Total Occlusion Lesions
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DOI：
10.1177/0003319717752245
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发表时间：
2019-03-01
期刊：
影响因子：
2.8
通讯作者：
Ge, Junbo
中科院分区：
文献类型：
--
作者：
Li, Chenguang;Shen, Yi;Ge, Junbo
这项回顾性、单中心研究评估了几种新兴炎症标志物作为冠状动脉慢性完全闭塞（CTO）病变药物洗脱支架植入后支架内再狭窄（ISR）预测因子的预后价值。连续纳入因 CTO 病变而成功接受经皮冠状动脉介入治疗 (PCI) 并进行后续血管造影的患者 (n = 416)。分析术前高敏 C 反应蛋白 (hsCRP)、中性粒细胞与淋巴细胞比率 (NLR)、血小板与淋巴细胞比率 (PLR) 和红细胞分布宽度 (RDW)。平均随访 14.4 +/- 3.3 个月，72 名患者出现 ISR。与非ISR组相比，ISR组术前hsCRP水平、PLR、NLR和RDW显着升高。 ISR 组的糖尿病和吸烟史患者比例也明显较高，估计肾小球滤过率较低，低密度脂蛋白胆固醇 (LDL-C) 水平和中性粒细胞计数较高，支架长度较长，严重夹层发生率较高。在多变量分析中，NLR（比值比 [OR]：3.110；95% 置信区间 [CI]，2.102-4.063；P < .001）和 PLR（OR：1.029；95% CI，1.016-1.143；P < .001）以及 LDL-C 水平和支架长度是 ISR 的独立预测因子。总之，较高的术前 NLR 和 PLR 水平是因 CTO 病变接受 PCI 的患者发生 ISR 的独立危险因素。
This retrospective, single-center study assessed the prognostic value of several emerging inflammatory markers as predictors of in-stent restenosis (ISR) after drug-eluting stent implantation for coronary chronic total occlusion (CTO) lesions. Consecutive patients (n = 416) who underwent successful percutaneous coronary intervention (PCI) for documented CTO lesions and with follow-up angiography were enrolled. Preprocedural high-sensitivity C-reactive protein (hsCRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) were analyzed. At mean follow-up of 14.4 +/- 3.3 months, ISR occurred in 72 patients. Compared with the non-ISR group, preprocedural hsCRP level, PLR, NLR, and RDW were significantly higher in the ISR group. The ISR group also had significantly greater proportions of patients with diabetes and smoking history, lower estimated glomerular filtration rate, higher low-density lipoprotein cholesterol (LDL-C) level and neutrophil count, longer stent length, and higher rate of severe dissection. In multivariate analysis, NLR (odds ratio [OR]: 3.110; 95% confidence interval [CI], 2.102-4.063; P < .001) and PLR (OR: 1.029; 95% CI, 1.016-1.143; P < .001) were independent predictors of ISR, along with LDL-C level and stent length. In conclusion, higher preprocedural NLR and PLR levels were independent risk factors for the development of ISR in patients who underwent PCI for CTO lesions.