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Global Translational Medicine Prediction of in-stent restenosis
Table 1. Systematic analysis of studies related to coronary stenosis predictors
Study topic Number of patients Number of Analysis tool Restenosis predictors identified
restenosis cases
Predictors of restenosis 1,795 125 Multivariate analysis Lesion length, stent length, minimum lumen
after DES implantation diameter after intervention, minimum lumen
in one or more coronary diameter before intervention, reference
arteries artery size, complex lesions, and use of the
paclitaxel-eluting stent
Occurrence and predictive 398 37 Multivariate analysis Demographic characteristics (age),
factors of restenosis cardiovascular risk factors (hypertension and
in CHD patients with hyperuricemia), biochemical indexes (fasting
sirolimus-eluting stent blood glucose, total cholesterol, LDL-C, and
implantation HsCRP), cardiac function index (cardiac
troponin I), lesion features (multivessel artery
lesions, target lesion at left circumflex artery
(LCX), two target lesions, length of target
lesion, and operation procedure (length of
stent) correlated with higher restenosis risk; age,
hypertension, diabetes mellitus, LDL-C, HsCRP,
and target lesion at LCX were independent
predictive factors for increased restenosis risk
Predictors of restenosis 134 55 Univariate and Diabetes mellitus, acute coronary syndrome,
after implantation of multivariate analysis lesion length, bifurcation lesion, lower LVEF,
2.5-mm diameter stents in stent strut, stent/artery ratio, and stent length
small coronary arteries were identified as predictors of restenosis by
univariate analysis; subsequent multivariate
analysis revealed that lower LVEF (OR: 3.37;
P=0.01), bifurcation lesion (OR: 2.47; P=0.04),
thicker stent strut (OR: 2.30; P=0.04), and
longer stent length (OR: 1.05; P=0.02) were
significant predictors of restenosis
Relationship between 126 42 Logistic regression; Five significant risk factors of restenosis were
the level of circulating ROC analysis identified by binary comparisons of different
CD45+platelets and variables: level of CD45-positive platelets,
development of restenosis diabetes mellitus, small vessel of stent, number
after implantation of DES of simultaneously implanted stents in one
in patients with CHD patient, and lesion length demonstrates
ISR risk (OR: 22.8; P<0.001); ROC analysis
demonstrated a high prognostic value of the
logit model (AUC: 0.87; P<0.001)
CHA DS -Vasc and 358 98 Multivariate logistic Compared with the non-ISR group, more
2
2
CHA DS -Vasc-HS scores regression analysis patients in the ISR group had diabetes mellitus
2
2
are poor predictors of ISR and received stents with smaller diameters but
in patients with coronary longer lengths; multivariate logistic regression
DES analyses demonstrated that stent diameter,
follow-up duration, and glycosylated hemoglobin
were independent risk factors for ISR
Use of NLR for prediction 181 47 ROC analysis NLR (before stenting; P<0.001) was significantly
of ISR in bifurcation higher in the group with restenosis; NLRΔ was
lesions found to be a significant independent predictor
of ISR from the multivariate logistic regression
analysis; NLRΔ level>0.58 mg/dL had 81.8%
sensitivity and 93.5% specificity for the prediction
of ISR; NLR level (after stenting) >3.43 mg/dL
predicted ISR with 45.5% sensitivity and 95.8%
specificity; NLRΔ was the strongest independent
predictor of ISR (P=0.001).
Abbreviations: DES: Drug-eluting stent; CHD: Coronary heart disease; HsCRP: High-sensitivity C-reactive protein; ISR: In-stent restenosis;
LDL-C: Low-density lipoprotein; LVEF: Left ventricular ejection fraction; NLR: Neutrophil-to-lymphocyte ratio; OR: Odds ratio; AUC: Area under the
curve; ISR: In-stent restenosis.
Volume 3 Issue 4 (2024) 5 doi: 10.36922/gtm.4957
