Blood level of CD45+platelets and development of restenosis after drug-eluting stent implantation in patients with stable coronary artery disease
Blood level of CD45+platelets and development of restenosis after drug-eluting stent implantation in patients with stable coronary artery disease
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DOI：
10.1007/s00508-016-1074-x
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发表时间：
2016-12-01
影响因子：
2.6
通讯作者：
Smirnov, Vladimir
中科院分区：
文献类型：
--
作者：
Gabbasov, Zufar;Kozlov, Sergey;Smirnov, Vladimir
为探讨CD 45阳性血小板（CD 45 + platelets）在稳定型冠状动脉疾病（stable coronary artery disease，CAD）患者药物洗脱支架（drug eluting stent，DES）术后再狭窄发生中的作用，选择126例稳定型心绞痛患者，行DES支架术，随访6-12个月。根据随访血管造影结果将患者分为再狭窄组（n = 53）和无再狭窄组（n = 73）。在两组中，我们比较了血液中CD 45+血小板的水平，临床，实验室和血管造影变量，这可能会影响再狭窄的发展。我们还建立了DES植入后再狭窄发生预后的logit回归模型，再狭窄患者的CD 45+血小板计数高于无再狭窄患者：0.82%（0.58; 1.12）vs. 0.34%（0.20; 0.68），p < 0.001，数据以中位数（下四分位数;上四分位数）表示。通过对超过35个不同的临床、实验室和血管造影变量进行二元比较，我们确定了DES后支架再狭窄发生的8个显著风险因素。为了确定再狭窄发生的风险，我们建立了一个logit回归模型。得到的logit回归方程包括CD 45+血小板水平、中性粒细胞与淋巴细胞比率（NLR）、小直径动脉支架植入和一名患者同时植入支架的数量。受试者工作特征（ROC）曲线分析表明，logit回归方程的曲线下面积（AUC）为0.91%（p < 0.001），具有较高的预后价值。
The aim of this study was to assess CD45-positive platelets (CD45+ platelets) involvement in restenosis development after drug-eluting stent (DES) implantation in patients with stable coronary artery disease (CAD).The study comprised 126 male and female patients with stable angina pectoris, who underwent elective coronary stenting with DES and follow-up angiography within 6-12 months. The patients were assigned to the group with restenosis (n = 53) or group without restenosis (n = 73) according to the follow-up angiograms. In both groups we compared the level in blood of CD45+ platelets, the clinical, laboratory and angiographic variables, which may affect the development of restenosis. We have also constructed a logit regression model for prognosis of restenosis occurrence after DES implantation.The blood count of CD45+ platelets was higher in patients with restenosis than in patients without: 0.82 % (0.58; 1.12) vs. 0.34 % (0.20; 0.68), p < 0.001, data are expressed as median (lower quartile; upper quartile). By binary comparisons of more than 35 different clinical, laboratory and angiographic variables we identified 8 significant risk factors for the development of stent restenosis after DES. In order to define the risk of the development of restenosis, we have built a logit regression model. The resulting logit regression equation included the level of CD45+ platelets, the neutrophil to lymphocyte ratio (NLR), small diameter arteries stenting and the number of simultaneously implanted stents in one patient. Receiver operating characteristic (ROC) curve analysis has demonstrated the high prognostic value of the resulting logit regression equation with an area under the curve (AUC) of 0.91 % (p < 0.001).The acquired data indicate the presence of a close relationship between circulating CD45+ platelets and restenosis development after DES implantation in patients with stable CAD.