Abstract：Objective To study the incidence and risk factor of in-stent restenosis (ISR) in elderly coronary heart disease (CHD) patients after percutaneous coronary intervention (PCI), and provide basis for prevention and control of ISR. Methods Clinical data of 475 cases receiving 12-month follow-up and coronary arteriography recheck were collected. Incidence of ISR was analyzed and compared between groups. Patients were grouped according to occurrence of ISR, and correlative factor was compared between ISR group and non-ISR groups to screen variables for multi-factor Logistic analysis. Results Totally 475 CHD patients completed follow-up after PCI, with 611 stent implantation, and 51 (10.67%) patients with 71 (11.62) stents encountered ISR. ISR rate of male (12.24%) was higher than that of female (6.82%) with statistical significance (P<0.05). Single-factor analysis revealed there was difference of complication with T2DM, hsCRP level, stent diameter, stent length, and stent number between both groups (P<0.05). Multi-factor analysis revealed complication with T2DM (OR=2.467, 95%CI: 1.455~5.767), hsCRP level (OR=6.515,95%CI: 2.455~18.767), stent diameter (OR=4.120, 95%CI: 1.574~14.644), stent length (OR=1.996, 95%CI: 1.387~3.895), and stent number (OR=3.425, 95%CI: 1.812~6.774) were independent factors of ISR. Conclusion ISR incidence after PCI was still high, and complication with T2DM, high hsCRP level, short stent diameter, long stent, and a large number of stents could be risk factors of ISR after PCI.
张小芳, 何文君. 冠心病老年患者经皮冠动脉介入治疗术后支架内再狭窄发生率及危险因素研究[J]. 中国医院统计, 2017, 24(1): 1-4.
Zhang Xiaofang, He Wenjun. Study on the incidence and risk factor of in-stent restenosis in elderly coronary heart disease patients after percutaneous coronary intervention. journal1, 2017, 24(1): 1-4.
[1] 卢长林,郭炜华,杨跃进,等.冠状动脉支架内再狭窄的现状与展望[J].中国心血管杂志,2012,17(6):409-412. [2] HALL JE. Guyton and hall textbook of medical physiology[M].12版.北京:北京大学医学出版社,2012. [3] HYTONEN J, LEPPANEN O, BRAESEN JH, et al. Activation of Peroxisome Proliferator-Activated Receptor-δ as Novel Therapeutic Strategy to Prevent In-Stent Restenosis and Stent Thrombosis[J]. Arterioscler Thromb Vasc Biol, 2016,36(8):1534-1548. [4] TOMOI Y, SOGA Y, IIDA O, et al. Impact of Drug-Eluting Stent Implantation for Femoropopliteal In-Stent Occlusion[J]. J Endovasc Ther, 2016,32(3):461-467. [5] MEHANNA E, ATTIZZANI GF, NAKAMURA D, et al. Impact of Neointimal Calcifications on Acute Stent Performance during the Treatment of In-Stent Restenosis[J]. Arq Bras Cardiol, 2016,105(6):419-421. [6] 李巍,黄岚.PCI 术后再狭窄的病理生理及其危险因素[J].中国动脉硬化杂志,2013,21(4):375-378. [7] WIEBE J, HOPPMANN P, KUFNSER S, et al. Impact of stent size on angiographic and clinical outcomes after implantation of everolimus-eluting bioresorbable scaffolds in daily practice: insights from the ISAR-ABSORB registr[J]. EuroIntervention, 2015,12(1):e137-143. [8] SCHAFFER A, VERDOIA M, BARBIERI L, et al. Impact of Diabetes on Homocysteine Levels and Its Relationship with Coronary Artery Disease: A Single-Centre Cohort Study[J]. Ann Nutr Metab, 2016,68(3):180-188. [9] PETERS SA, WOODWARD M, RUMLEY A, et al. Direct comparisons of three alternative plasma fibrinogen assays with the von clauss assay in prediction of cardiovascular disease and all-causes mortality: the Scottish Heart Health Extended Cohort[J]. Br J Haematol, 2013,162(3):392-399. [10]杜博,赵学忠.冠心病患者支架内再狭窄的危险因素[J].中国老年学杂志,2015,35(10):2708-2710. [11]陈涛,张春晓,米杰,等.冠心病合并糖尿病患者PCI术后支架内再狭窄相关因素分析[J].山东医药,2014,54(30):50-52. [12]ABRAMOWITZ Y, CHAKRAVARTY T, JILAIHAWI H, et al. Clinical impact of coronary protection during transcatheter aortic valve implantation: first reported series of patients[J]. EuroIntervention, 2015,11(5):572-581. [13]张诚佳,赵良平,徐卫亭,等.血清Adropin水平与冠状动脉支架内再狭窄的关系[J].中国动脉硬化杂志,2014,22(11):1123-1125. [14]NDREPEPA G, BRAUN S, KING L, et al. Relation of fibrinogen level with cardiovascular events in paptents with coronary artery diseas[J]. Clin Sci (Lond), 2013,111(6):804-810.
