Occurrence and predictive factors of restenosis in coronary heart disease patients underwent sirolimus-eluting stent implantation

Ir J Med Sci. 2020 Aug;189(3):907-915. doi: 10.1007/s11845-020-02176-9. Epub 2020 Jan 27.

Abstract

Background: This study aimed to investigate the occurrence and predictive factors of restenosis in coronary heart disease (CHD) patients underwent percutaneous coronary intervention (PCI) with sirolimus-eluting stent (SES).

Methods: Demographic data, clinical features, and laboratory tests of 398 CHD patients underwent PCI with SES were retrospectively reviewed. Coronary angiography was performed to evaluate coronary stenosis before PCI and in-stent restenosis at 1-year follow-up.

Results: There were 37 (9.3%) patients suffered restenosis, but 361 (90.7%) patients did not develop restenosis at 1-year follow-up. Demographic characteristic (age), cardiovascular risk factors (hypertension and hyperuricemia), biochemical indexes (fasting blood-glucose, total cholesterol, low density lipoprotein cholesterol (LDL-C) and high-sensitivity C-reactive protein (HsCRP)), cardiac function index (cardiac troponin I), lesion features (multivessel artery lesions, target lesion at left circumflex artery (LCX), two target lesions and length of target lesion), and operation procedure (length of stent) were correlated with higher restenosis risk. Moreover, age, hypertension, diabetes mellitus, LDL-C, HsCRP, and target lesion at LCX were independent predictive factors for raised restenosis risk. Based on these independent predictive factors, we established a restenosis risk prediction model, and receiver-operating characteristic curves displayed that this model exhibited an excellent predictive value for higher restenosis risk (areas under the curve 0.953 (95% CI 0.926-0.981)).

Conclusion: Our findings provide a new insight into the prediction for restenosis in CHD patients underwent PCI with SES.

Keywords: Coronary heart disease; Percutaneous coronary intervention; Predictive factor; Restenosis; Sirolimus-eluting stent.

MeSH terms

  • Coronary Restenosis / etiology*
  • Drug-Eluting Stents / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / adverse effects*
  • Percutaneous Coronary Intervention / methods
  • Retrospective Studies
  • Risk Factors
  • Sirolimus / pharmacology
  • Sirolimus / therapeutic use*
  • Treatment Outcome

Substances

  • Sirolimus